To the Editor.— Drs Parker and Tuazon have succinctly described two patients with vertebral osteomyelitis acquired in association with chronic hemodialysis (240:50, 1978). Other reports have suggested urinary tract disease,1 intravenous drug abuse,2 and indwelling intravenous catheters3 as the route of entry.In a review of our experience with vertebral osteomyelitis among insulin-dependent diabetics,4 we uncovered only one with chronic bacteriuria and one with prior osteomyelitis as potential portals of entry. Subsequently, we have observed vertebral osteomyelitis in an immunosuppressed patient following successful renal transplantation at a time when glucocorticoid-induced diabetes had developed. We have not found vertebral osteomyelitis in our dialysis patients.Thus, we would emphasize the importance of underlying systemic disease in predisposition to vertebral osteomyelitis, as well as the probability of an increased incidence with the use of immunosuppressive drugs. The absence of an obvious portal of entry reinforces the concept of a diagnostic
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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