Septic arthritis in patients with sickle-cell disease

Area of Science:

• Orthopedics
• Infectious Diseases
• Hematology

Background:

• Sickle-cell disease (SCD) is a prevalent genetic disorder in Nigeria, increasing susceptibility to infections.
• Septic arthritis, a serious joint infection, poses significant challenges in SCD patients.
• Understanding the specific patterns of septic arthritis in this population is crucial for effective management.

Purpose of the Study:

• To prospectively investigate the clinical features, treatment modalities, and outcomes of septic arthritis in Nigerian patients with sickle-cell disease.
• To identify common causative organisms and associated complications.
• To analyze the impact of diagnostic delays and joint involvement on patient sequelae.

Main Methods:

• Prospective study over 66 months involving 31 Nigerian patients with SCD and septic arthritis.
• Data collection included presenting features, diagnostic methods, treatment approaches, and complications.
• Microbiological analysis to identify causative pathogens, with a focus on Gram-negative organisms like Salmonella.

Main Results:

• Fifty joints in 31 patients were studied; most were young males, with the hip being the most affected site.
• Polyarticular involvement occurred in 39%, and 84% had associated osteomyelitis.
• Gram-negative infections predominated, with Salmonella as the most frequent organism; 76% experienced severe complications.

Conclusions:

• Septic arthritis in Nigerian SCD patients is frequently polyarticular, associated with osteomyelitis, and often caused by Salmonella.
• Delayed diagnosis and hip joint involvement are significant factors contributing to severe complications.
• Conservative treatment was common, with limited arthrotomy; improved diagnostic timeliness is essential to reduce morbidity.