Treatment of multifocal vancomycin-resistant Enterococcus faecium osteomyelitis in sickle cell disease: a preliminary...

Area of Science:

• Infectious Diseases
• Hematology
• Orthopedics

Background:

• Sickle cell disease (SCD) patients are prone to recurrent infections, including osteomyelitis, due to repeated musculoskeletal infarctions and immunosuppression.
• Staphylococcus and Salmonella are common pathogens in SCD-related osteomyelitis; however, Vancomycin-resistant Enterococcus (VRE) infections, particularly in the musculoskeletal system, are increasingly concerning.
• VRE osteomyelitis is rare but poses a significant clinical challenge, especially in immunocompromised SCD patients.

Observation:

• A case of multiple long bone Vancomycin-resistant Enterococcus faecium osteomyelitis in a sickle cell patient is presented.
• This patient had a complicated VRE infection, necessitating novel treatment strategies.
• The infection involved mixed organisms, complicating the management approach.

Findings:

• Quinupristin-dalfopristin was successfully employed as part of the management plan for a complicated VRE osteomyelitis in a sickle cell patient.
• This case demonstrates a potential new therapeutic avenue for treating challenging VRE bone infections.
• The study discusses the mechanism of action of anti-VRE drugs relevant to orthopedic infections.

Implications:

• The findings suggest that quinupristin-dalfopristin can be an effective treatment option for VRE osteomyelitis in immunocompromised patients, including those with sickle cell disease.
• This research contributes to the limited literature on VRE long bone osteomyelitis and its management.
• Further research into combating VRE in orthopedic infections is warranted, exploring novel drug combinations and treatment protocols.