Mallouh A, Talab Y
J Pediatr Orthop. 1985 Mar-Apr;5(2):158-62.
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.
由于近期文献报道镰状细胞病患者发生骨髓炎的情况罕见，我们回顾了达兰健康中心（沙特阿拉伯达兰）5年的经验。在镰状细胞病患者中发现了12例骨和/或关节感染病例；83%由沙门氏菌引起。这种相对较高的发病率可能与该地区沙门氏菌感染的常见情况有关。发现长骨和多部位受累。与急性骨梗死进行鉴别诊断很困难，建议采用系统且积极的方法进行早期诊断、治疗和随访。在开始治疗前，应详细询问病史、进行体格检查、进行血培养、局部培养、粪便和尿液培养，并检测发热凝集素水平。一旦确诊或高度怀疑，应进行充分的手术引流、延长胃肠外抗生素治疗时间，并输注浓缩红细胞。建议进行长期随访。
