LOW BACK PAIN AND FEVER IN A DIALYSIS PATIENT

by Konstantina C. Goula, Pavlos C. Goudas, Ourania S. Drakoulogkona, Athanasios A. Diamandopoulos

St Andrews General State Hospital, Patras, Greece.

Corresponding author:

Download short CV of the first author (Konstantina Goula)

CASE VIGNETTE:
In January 2007, an 80 year-old man, on regular dialysis for 3 years, presented with low back pain which had started 15 days before and fever up to 39º C with chills. His recent medical history was uneventful. His past history included coronary heart disease and hypertension. A right permanent jugular catheter had been placed eight months before and was still used as a vascular access for dialysis.
Two temporary femoral catheters were inserted because of vascular access failure and were used for a few days eight months and twenty-three months before.
On physical examination his temperature was 39,3ºC. There were no heart murmurs. Applying pressure on the lumbar spine provoked pain.
Laboratory studies showed an ESR of 90mm/h, leukocytes 18000/mm³ and CRP 11mg/dl. Blood cultures were negative.