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Old 04-24-2012
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RBC Sickle Cell Disease and Osteomyelitis?

A 7-year-old African-American boy is brought into the emergency department with a 5-day history of fever and pain over the upper left leg. The leg is painful to move. He has a history of sickle cell disease. On examination, his body temperature is 39.2C (102.5F) and the left proximal anterior leg is erythematous and swollen. There is particular tenderness directly over the femur. An X-ray and bone scan strongly suggest osteomyelitis. What is the most likely etiologic agent for these findings?

A. Escherichia coli
B. Kingella kingae
C. Pseudomonas aeruginosa
D. Salmonella spp
E. Staphylococcus aureus
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Old 04-24-2012
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D) Salmonella.

The most common cause of osteomyelitis in general population - Staph aureus, but in Sickle Cell Disease-suffering ppl it is Salmonella
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Salmonella
(SCA patients are more susceptible to encapsulated bacterial infections)
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Quote:
Originally Posted by DocSikorski View Post
D) Salmonella.

The most common cause of osteomyelitis in general population - Staph aureus, but in Sickle Cell Disease-suffering ppl it is Salmonella
Thx saved a question ,didn't known connect b/w salmo n sickle
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Salmonella is an encapsulated bacteria...
Sickle cell patients tend to become aesplenic, cant fight encapsulated bacteria, more risk to be infected with them...
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Quote:
Originally Posted by jriella View Post
Salmonella is an encapsulated bacteria...
Sickle cell patients tend to become aesplenic, cant fight encapsulated bacteria, more risk to be infected with them...
Asplenic means dec immunity I doubt there is relation to encapsulated bact ?
If threre is can you explain please
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Old 04-25-2012
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The spleen is responsible for killing encapsulated bacteria.
If you dont have spleen, you are at higher risk of infections by these bact, as strept pneumoniae, h influenzae, salmonella... Thats why pts with sickle cell dx have to be immunized with pneumoccoco vaccine and haemophilus...
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Old 04-25-2012
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SSHiN

pneumonic for encapsulated bacteria:
Salmonella, Streptococcus pneumonia, Hemophilues influenza, Nesseria meningitidis

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Old 04-25-2012
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SSHiN

pneumonic for encapsulated bacteria:
Salmonella, Streptococcus pneumonia, Hemophilues influenza, Nesseria meningitidis

are u sure salm is capsulated?
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It has nothing to do with incapsulation!!
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Quote:
Originally Posted by DocSikorski View Post
It has nothing to do with incapsulation!!
REALLY? Read UW question ID: 1137

Salmonella has Vi antigen, a special capsule that protects from phagocytosis and opsonization.
Patients with aesplenism due to sickle cell disease or trauma are prone to develop Salmonella osteomyelitis due to defective protection against them.

Yes, salmonella is encapsulated, just read FA or google it.. damn
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Come on guys!

Check out FA micro section, the very first few pages. There's a paragraph on encapsulated bacteria that should sort everything out
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Quote:
Originally Posted by jriella View Post
REALLY? Read UW question ID: 1137

Salmonella has Vi antigen, a special capsule that protects from phagocytosis and opsonization.
Patients with aesplenism due to sickle cell disease or trauma are prone to develop Salmonella osteomyelitis due to defective protection against them.

Yes, salmonella is encapsulated, just read FA or google it.. damn
Wow! JarJar, you need to relax, my friend.
The literature nowadays is full of case reports associated with salmonella osteomyelitis in patients (and children particularly) with sickle cell disease.
Usually these pt's have bones with enlarged haversian channels which makes it possible for salmonella to enter the bone and start lysis.
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Hematology-, Infectious-Diseases, Pediatrics-, Step-2-Questions

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