Related Experiment Videos
Bone and joint infection in patients with sickle cell disease
Abstract:
Because of recent literature reports of the rare occurrence of osteomyelitis in patients with sickle cell disease, we reviewed 5 years of experience at Dhahran Health Center (Dhahran, Saudi Arabia). Twelve cases of bone and/or joint infection were identified in patients with sickle cell disease; 83% caused by Salmonella species. This relatively high incidence might be related to the common occurrence of infection with Salmonella in this region. Long bone and multiple site involvements were noticed. Differentiation from acute bone infarcts is difficult, and a systemic and aggressive approach to early diagnosis, management, and follow-up is suggested. Before therapy is started, full history, physical examination, blood cultures, local cultures, stool and urine cultures, and measurement of febrile agglutinin levels should be done. Once diagnosis is confirmed or highly suspected, adequate surgical drainage, prolonged parenteral antibiotic therapy, and transfusion of packed red blood cells should be used. A prolonged follow-up is recommended.
Insights
Osteomyelitis is rare in sickle cell disease but common in Saudi Arabia, often caused by Salmonella. Early diagnosis and aggressive treatment, including surgery and antibiotics, are crucial for managing bone infections in these patients.
Area of Science:
- Infectious Diseases
- Hematology
- Orthopedics
Background:
- Osteomyelitis is infrequently reported in sickle cell disease patients.
- Recent literature suggests a potential increase in occurrence.
- Sickle cell disease patients are susceptible to various infections.
Purpose of the Study:
- To review the incidence and characteristics of bone and joint infections in sickle cell disease patients.
- To investigate the causative pathogens and treatment outcomes.
- To highlight diagnostic and management challenges.
Main Methods:
- Retrospective review of 5 years of patient data at Dhahran Health Center.
- Identification of cases with bone and/or joint infections in sickle cell disease patients.
- Analysis of clinical presentation, microbiology, treatment, and outcomes.
Main Results:
- Twelve cases of bone and/or joint infection were identified.
- Salmonella species were the causative agent in 83% of cases.
- Long bone and multiple site involvement were common; differentiation from bone infarcts was challenging.
Conclusions:
- A high incidence of Salmonella-related osteomyelitis in sickle cell disease patients in this region is noted.
- A systemic, aggressive approach to early diagnosis, management, and follow-up is recommended.
- Treatment involves surgical drainage, prolonged parenteral antibiotics, and packed red blood cell transfusions.