Guedenon Koffi Mawuse, Akolly Djatougbe Ayaovi Elie, Fiawoo Mawouto, Dossou Fidèle Comlan, Takassi Ounoo Elom, Djadou Koffi Edem, Atakouma Yawo Dzayissé, Gbadoe Adama Dodji
Département de Pédiatrie, CHU Sylvanus Olympio, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.
Pan Afr Med J. 2024 Apr 3;47:162. doi: 10.11604/pamj.2024.47.162.33754. eCollection 2024.
vaso-occlusive crisis (VOC) is the most common manifestation of sickle cell disease and the leading cause of hospitalization among affected children. The purpose of this study is to describe the clinical features of severe VOCs, to determine the etiologies of infectious syndromes that accompany them and to describe their management.
we conducted a descriptive cross-sectional study of 137 adult patients with sickle cell disease hospitalised for severe VOC in the Paediatric Department of the Sylvanus Olympio University Hospital from 1 January 2009 to 31 December 2011.
the majority of patients (n=98; 71.5%) had homozygous sickle cell (SS), followed by double heterozygous SC disease (n=28; 20.5). The median of consultation time was 4.7 ± 4.4 days. Treatment before admission was based on antibiotics (28.5%). VOCs were mainly osteoarticular (70.8%). In 98.5% of cases, an associated bacterial infection was confirmed (48.9%) or suspected (49.6%). The main etiologies included acute chest syndrome (26.3%), acute osteomyelitis (10.9%), urinary tract infection (6.6%) and septicaemia (3.6%). One germ was isolated from 14.6% of patients: Escherichia coli (30%), followed by Klebsiella pneumoniae (25%), Staphylococcus aureus (15%), Salmonella typhi (10%), Streptococcus pneumoniae (5%), Streptococcus D (5%), Enterobacter (5%) and Acinetobacter (5%). Mortality rate was 2.2%. The average length of stay in hospital was 11.4 ± 8.8 days.
severe sickle cell-related vaso-occlusive crisis is mainly associated with bacterial infections in tropical environments. Appropriate and early antibiotic therapy is the essential therapeutic means to prevent or treat these patients.
血管闭塞性危机（VOC）是镰状细胞病最常见的表现，也是患病儿童住院的主要原因。本研究的目的是描述严重VOC的临床特征，确定伴随其出现的感染综合征的病因，并描述其治疗方法。
我们对2009年1月1日至2011年12月31日在西尔瓦努斯·奥林匹奥大学医院儿科住院治疗严重VOC的137例成年镰状细胞病患者进行了描述性横断面研究。
大多数患者（n = 98；71.5%）为纯合子镰状细胞（SS），其次是双杂合子SC病（n = 28；20.5%）。会诊时间中位数为4.7±4.4天。入院前治疗以使用抗生素为主（28.5%）。VOC主要为骨关节性（70.8%）。在98.5%的病例中，确诊（48.9%）或疑似（49.6%）存在相关细菌感染。主要病因包括急性胸综合征（26.3%）、急性骨髓炎（10.9%）、尿路感染（6.6%）和败血症（3.6%）。14.6%的患者分离出一种病菌：大肠杆菌（30%），其次是肺炎克雷伯菌（25%）、金黄色葡萄球菌（15%）、伤寒沙门菌（10%）、肺炎链球菌（5%）、D群链球菌（5%）、肠杆菌（5%）和不动杆菌（5%）。死亡率为2.2%。平均住院时间为11.4±8.8天。
在热带环境中，严重的镰状细胞相关血管闭塞性危机主要与细菌感染有关。适当且早期的抗生素治疗是预防或治疗这些患者的关键治疗手段。
