Acute osteomyelitis in Nigerians with sickle cell disease

Area of Science:

• Pediatrics
• Infectious Diseases
• Hematology

Background:

• Sickle cell disease (SCD) predisposes patients to significant skeletal complications.
• Osteomyelitis is a frequent and serious manifestation in SCD, especially in pediatric populations.

Purpose of the Study:

• To investigate the incidence, characteristics, and outcomes of acute osteomyelitis in patients with sickle cell disease.
• To identify common pathogens and evaluate treatment strategies for osteomyelitis in this high-risk group.

Main Methods:

• Retrospective analysis of 207 patients with sickle cell disease over a 5.5-year period.
• Data collection included skeletal complications, patient demographics, causative organisms, and treatment regimens.
• Outcomes assessed included treatment adequacy and development of serious complications.

Main Results:

• Acute osteomyelitis accounted for 29.3% of major skeletal complications (78/266).
• The majority of affected patients (61.5%) were under 15 years old, with a mean age of 12 years.
• Salmonella was the most common pathogen (50% of isolates), and multifocal infections occurred in 42% of cases.
• Chloramphenicol and cloxacillin were the preferred antibiotic combination.
• While no deaths occurred, 55% of patients experienced serious complications, often involving epiphyses and joints.

Conclusions:

• Acute osteomyelitis is a significant concern in sickle cell disease management, necessitating prompt diagnosis and treatment.
• Early and appropriate antibiotic therapy, often a combination regimen, is crucial.
• Despite effective medical treatment, the high rate of serious complications highlights the need for vigilant monitoring and management of bone and joint health in SCD patients.