Pediatric osteomyelitis: II. Arizona hinshawii osteomyelitis

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Bone Infections

Background:

• Sickle cell disease (SCD) and kwashiorkor are severe pediatric conditions that predispose individuals to infections.
• Osteomyelitis, a serious bone infection, can have significant morbidity in immunocompromised or malnourished children.
• Arizona hinshawii, a bacterium closely related to Salmonella, is an uncommon but potential pathogen.

Observation:

• Two pediatric patients presented with concurrent sickle cell disease and kwashiorkor.
• Both children developed osteomyelitis, a severe bone infection.
• Cultures identified the causative agent as Arizona hinshawii.

Findings:

• Arizona hinshawii was confirmed as the pathogen responsible for osteomyelitis in these vulnerable children.
• The clinical presentation highlights a rare but serious infection in children with combined SCD and kwashiorkor.
• Successful treatment involved a combination of surgical intervention and antibiotic therapy.

Implications:

• This case underscores the importance of considering Arizona hinshawii in the differential diagnosis of osteomyelitis in children with SCD and malnutrition.
• Prompt diagnosis and appropriate management, including surgical drainage and targeted antibiotics like chloramphenicol, are crucial for favorable outcomes.
• Further research may be warranted to understand the specific pathogenesis and risk factors associated with Arizona hinshawii infections in this patient population.