Chronic osteomyelitis in patients with sickle cell disease

Area of Science:

• Orthopedics
• Infectious Diseases
• Hematology

Background:

• Chronic osteomyelitis is a significant complication in patients with sickle cell disease.
• Understanding the specific patterns and management of this condition in sickle cell disease patients is crucial for effective treatment.

Purpose of the Study:

• To determine the baseline pattern of chronic osteomyelitis in patients with sickle cell disease.
• To audit the management modalities employed for chronic osteomyelitis in this patient population.

Main Methods:

• A retrospective study was conducted at Jos University Teaching Hospital, Nigeria, from August 1993 to July 1997.
• Data from 24 patients with chronic osteomyelitis and sickle cell disease were analyzed, including demographic information, etiological agents, culture and sensitivity patterns, pathogenesis, treatment, and outcomes.

Main Results:

• Staphylococcus aureus was the most frequent pathogen (58.8%), followed by Gram-negative organisms (41.2%).
• Haematogenous spread accounted for 75% of infections, with the first decade of life showing the highest incidence.
• Surgical interventions (sequestrectomy, curettage, incision, and drainage) and antibiotic therapy were utilized, with gentamicin and third-generation cephalosporins showing good sensitivity. Fifty percent of patients achieved good outcomes.

Conclusions:

• Gram-negative organisms play a substantial role in chronic osteomyelitis among sickle cell disease patients.
• The absence of Salmonella osteomyelitis in this cohort may be influenced by local endemicity, warranting further investigation.