Cervical osteomyelitis. Infection due to Staphylococcus epidermidis in hemodialysis patients

VERTEBRAL bodies are frequent sites of pyogenic osteomyelitis in the adult.¹⁻³Anatomically, lumbar vertebrae are most commonly involved, followed by thoracic and, rarely, cervical vertebrae. In most series, vertebral osteomyelitis occurs in the setting of urinary tract disease²,⁴,⁵or intravenous (IV) drug use.²,³ The preponderant pathogen in pyogenic osteomyelitis isStaphylococcus aureus,¹,²followed by Gram-negative rods usually from a urinary tract focus.⁵Staphylococcus epidermidisis a rare cause of osteomyelitis.⁴,⁵The first report of osteomyelitis in hemodialysis patients implicatedS epidermidisin three of five cases, either as the sole etiologic agent or combined withS aureusorPseudomonas aeruginosa.⁶We describe two cases of cervical osteomyelitis due toS epidermidisin long-term hemodialysis patients. Report of Cases Case 1.— A 42-year-old man was admitted in February 1976, with complaints of neck and shoulder pains of three days' duration. He had a history