Infectious spondylodiscitis is an infection seen with increasing frequency in patients receiving chronic hemodialysis. Often accompanied by bacteremia, it is associated with the use of central venous catheters for hemodialysis access. Initial symptoms can be relatively insidious and nonspecific. Therefore, the clinician must have a low threshold for diagnostic testing that goes beyond blood cultures. This, in addition to early empiric antibiotic therapy, may improve the outcome of this potentially catastrophic infection.