AlFawaz Tariq, Alzumar Omar, AlShahrani Dayel, Alshehri Mohammed
Pediatric Infectious Diseases Section-children Specialized Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Saudi Arabia.
Pediatric infectious Diseases Section-children Hospital, King Saud Medical City, Riyadh, Saudi Arabia.
Int J Pediatr Adolesc Med. 2019 Sep;6(3):115-117. doi: 10.1016/j.ijpam.2019.05.001. Epub 2019 Jun 15.
Sickle cell disease (SCD) affects millions worldwide. It has a spectrum of clinical manifestations. However, SCD is more prone to have invasive infection compared with normal individual, and one of the main pathogen of concern is salmonella, where the individual with SCD is more susceptible to salmonella infection. Furthermore, several distinct clinical syndromes can develop in children infected with salmonella, depending on both host factors and the specific serotype involved.
We aim to describe the infection patterns and whole range of potential complications in children with SCD exposed to invasive salmonella infection.
This is a retrospective observational cohort study which was conducted at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia between 2012 and 2018. All sickle cell patients who are exposed to invasive salmonella infections and treated in our hospital over the last 6 years were included in our study.
Six patients were enrolled in the study, five males and one female with ratio of (M: F) 5:1, age range from 20 months-14 years, and the diagnosis at admission were as follows: (three as vasooclusive crisis, three as infection) with different kind of infections (three sepsis, three septic arthritis, four osteomyelitis, one meningitis, one myositis, one periorbital cellulitis, one diskitis), where three (50%) suffered multiple sites of infections and the other three (50%) with one site of infection, two (50%) of osteomyelitis patients suffered multifocal infection. Species identification is as follows: (three group D, one group C, and two were not specified), only two occasions where resistant to ciprofloxacin while all others were pan sensitive. Fever was prolonged (take more than seven days to subside even with appropriate therapy and intervention) in five out of six.
Multiple site of infection, sever osteomylitis, and delay in fever response consolidated the fact of high virulence of salmonella in SCD patients. We did not encounter significant resistant rate to both quinolone and cephalosporin.
镰状细胞病（SCD）在全球影响着数百万人。它有一系列临床表现。然而，与正常个体相比，SCD患者更易发生侵袭性感染，其中主要关注的病原体之一是沙门氏菌，SCD个体更容易感染沙门氏菌。此外，感染沙门氏菌的儿童可能会出现几种不同的临床综合征，这取决于宿主因素和所涉及的特定血清型。
我们旨在描述暴露于侵袭性沙门氏菌感染的SCD儿童的感染模式和所有潜在并发症。
这是一项回顾性观察队列研究，于2012年至2018年在沙特阿拉伯利雅得的法赫德国王医疗城（KFMC）进行。纳入了过去6年内在我院接受治疗的所有暴露于侵袭性沙门氏菌感染的镰状细胞病患者。
6例患者纳入研究，5例男性和1例女性，男女比例为5:1，年龄范围为20个月至14岁，入院诊断如下：（3例为血管闭塞性危机，3例为感染）伴有不同类型的感染（3例败血症、3例化脓性关节炎、4例骨髓炎、1例脑膜炎、1例肌炎、1例眶周蜂窝织炎、1例椎间盘炎），其中3例（50%）有多处感染，另外3例（50%）有一处感染，2例（50%）骨髓炎患者有多处感染。菌种鉴定如下：（3例D组，1例C组，2例未明确），仅2例对环丙沙星耐药，其他均对所有药物敏感。6例中有5例发热持续时间延长（即使经过适当治疗和干预，发热仍需7天以上才能消退）。
多处感染、严重骨髓炎和发热反应延迟证实了沙门氏菌在SCD患者中具有高毒力这一事实。我们未发现对喹诺酮类和头孢菌素类药物有显著耐药率。
