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Sickle cell disease and infection.

J K Onwubalili

    The Journal of Infection
    |July 1, 1983
    PubMed
    Summary

    Patients with sickle cell disease face severe infections from encapsulated bacteria and Salmonella. Prompt antibiotic treatment is crucial for managing life-threatening conditions like sepsis and meningitis, especially in young children.

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    Area of Science:

    • Hematology
    • Infectious Diseases
    • Pediatrics

    Background:

    • Sickle cell disease (SCD) patients exhibit increased susceptibility to overwhelming infections.
    • Key pathogens include encapsulated bacteria (Streptococcus pneumoniae, Haemophilus influenzae type b) and Salmonella species.
    • Plasmodium falciparum poses a risk in malarious regions.

    Purpose of the Study:

    • To review the spectrum of infections in sickle cell disease.
    • To discuss the predisposing factors for these infections.
    • To outline clinical presentations, management, and outcomes.

    Main Methods:

    • Literature review of infections in sickle cell disease.
    • Analysis of predisposing factors: functional asplenia, complement pathway defects, antibody deficiency.
    • Discussion of specific infections: bacterial meningitis, sepsis, salmonellosis, osteomyelitis, and chest syndrome.

    Main Results:

    • Streptococcus pneumoniae causes 70% of sepsis and meningitis in SCD children under five.
    • Salmonella species account for over 70% of hematogenous osteomyelitis.
    • The chest syndrome is the most common complication, often caused by Streptococcus pneumoniae.

    Conclusions:

    • Prompt intravenous antibiotic therapy is vital for sepsis and meningitis, with mortality rates up to 50%.
    • Distinguishing Salmonella osteomyelitis from bone crisis requires careful evaluation of radiographic signs.
    • Further research is needed on the efficacy of pneumococcal vaccines and long-term penicillin prophylaxis in SCD.

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