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[Sickle cell disease and invasive osteoarticular Salmonella infections]
A Millet1, E Hullo, C Armari Alla
1Service de pédiatrie générale, hôpital couple-enfant, CHU de Grenoble, avenue Maquis-du-Gresivaudan, 38700 La Tronche, France. AMillet@chu-grenoble.fr
Insights
Non-typhi Salmonella infections cause severe bone and joint issues in children with sickle cell disease. Early diagnosis and antibiotic treatment are crucial for favorable outcomes, even with multidrug-resistant strains.
Area of Science:
- Infectious Diseases
- Pediatrics
- Hematology
Context:
- Non-typhi Salmonella infections pose significant risks for children with sickle cell disease (SCD).
- Osteoarticular infections are a common and severe manifestation in pediatric SCD patients.
- Travel to endemic regions like North Africa increases exposure risk.
Purpose:
- To report two cases of paucisymptomatic Salmonella osteoarticular infections in children with SCD returning from North Africa.
- To highlight the importance of early clinical suspicion and prompt antibiotic treatment for invasive salmonellosis in pediatric SCD.
Summary:
- Two children with SCD presented with mild symptoms of Salmonella osteoarticular infections after travel.
- Both cases showed favorable outcomes with appropriate systemic antibiotic therapy.
- One Salmonella isolate was multidrug-resistant, underscoring treatment challenges.
Impact:
- Emphasizes the need for heightened clinical suspicion of invasive salmonellosis in febrile SCD patients, particularly those with recent travel history to Africa.
- Early empirical antibiotic treatment is critical for managing severe Salmonella infections in this vulnerable pediatric population.
- Highlights the potential for multidrug-resistant Salmonella strains in invasive infections.
Abstract:
Non-typhi Salmonella are responsible for severe invasive infections in children with sickle cell disease, with osteoarticular locations that can affect short- and long-term outcomes. We describe the cases of 2 children with sickle cell disease who presented paucisymptomatic Salmonella osteoarticular infections on returning from North Africa. Progression was favorable in both cases after appropriate systemic antibiotic therapy, although one Salmonella was multidrug-resistant. Invasive salmonellosis remains rare in France, but, because of its severity, it should be suspected in any patient with sickle cell disease presenting fever, especially in the context of recent trips in Africa countries. Early clinical diagnosis is essential to start appropriate empirical treatment without waiting for bacteriological results.
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