Hemodialysis Catheter-related Bloodstream Infection with Osteomyelitis: Case Reports

透析管路相關之血液感染合併骨髓炎—病例報告

10.6200/TCMJ.202409_21(3).0008

Hui-Hsuan Hong(洪惠萱)；Yung-Hsuen Hsu(徐永勳)

catheter-related bloodstream infection ； osteomyelitis ； hemodialysis ； 透析管路相關之血液感染 ； 骨髓炎 ； 血液透析

北市醫學雜誌

21卷3期（2024 / 09 / 30）

275 - 283

英文;繁體中文

Catheter-related bloodstream infection (CRBSI) is a frequently encountered complication of hemodialysis catheters, especially in patients with diabetes, hypoalbuminemia, and prolonged indwelling catheter use. CRBSI rate ranges from 15-40%. The most common pathogen is S aureus, with infectious endocarditis being the most common complication. Though less common, other complications, such as vertebral osteomyelitis (2%-15%), spinal epidural abscess, septic arthritis, and septic pulmonary emboli have been reported. Herein, we present two female diabetic patients who suffered from fever and back pain after receiving a doublelumen catheter for hemodialysis and were later diagnosed with osteomyelitis.

透析管路相關之血液感染是洗腎透析管路常見的一種合併症，尤其好發在糖尿病、營養不良、長期管路置放的患者身上。管路相關的血液感染發生率大約在15～40%，金黃色葡萄球菌是最常見的致病菌，其中又以感染性心內膜炎的合併症最常見。其他相關的感染還有：脊髓骨髓炎（2－15%）、脊髓硬膜外膿瘍、感染性關節炎及感染性肺栓塞等，但較為少見。在這篇文章中我們提出兩位糖尿病人，在接受雙腔靜脈導管置入術以進行血液透析之後，發生發燒、背痛的情形，後續診斷出骨髓炎的案例。

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