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Discussion Starter · #1 ·
Tho i have few days left before exam ... but still i m confuse about .. most common organism causing osteomyelitis in sickle cell ds ...
in UW ... i got Q ... when i ans salmonella they said its staph aureus ... in another ques when i choosed staph aureus they said its salmonella .... and i clearly remember a prof in kaplan said .... staph aureus is no 1 causes ...
can some one please give a solution soon .....
 

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Staph aureus is the most common

Normal patients: Staph aureus 80% Salmonella 5%
Sickle patients: Staph aureus 60% Salmonella 20%

The percentages above are just my creation (no reference) but I put them just to convey to you the idea.

A person with salmonella OM is most likely to be sickle but the reverse is not true, a sickle patient is NOT most likely to have salmonella OM.

It depends on the specific scenario and the wording of those questions that you have seen. Maybe they are both right.
 

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Discussion Starter · #3 ·
Yes u r rite .... but in UW ... they also gave reference of some pediatric books .. and also said its in debate , but their metanalysis shows mostly salmonella .... and said salmonella in SCD causes OM in 70 % cases and Staph aureus < 25 % cases .... But last month they said in a ques .. staph is most common ..... I agree wt u .... may b both are right ..... in that case ... to make this ques correct need luck in exam ....
 

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It's salmonella ... In patients with Sickle Cell Disease there is asplenia between the ages 3-5 due to small infarcts in the spleen which leads to decreased immunity against encapsulated organisms such as salmonella.
 

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if the question describes that the patient is presenting with osteomyelitis and it says what is the most common cause ?
the answer is staph aureus even if the patient has sickle cell disease
but if the question says what the organism most likely associated with this case?
the answer would be Salmonella
:confused: lets see another opinion also
 

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what i think is tht recently studies show that the staph aureus is the most common cause even in sickle cell patients and salmonella is a common cause in sca but if both of them were in the choices??
 

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what i think is tht recently studies show that the staph aureus is the most common cause even in sickle cell patients and salmonella is a common cause in sca but if both of them were in the choices??
what i learnt from my step1 experience is that there are no controversies in anything on this usmle exam series. they either give you staph or salmonella but never both of them! Thats what i like about these tests! They maintain their standard!
 

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OM and the common cause

what i learnt from my step1 experience is that there are no controversies in anything on this usmle exam series. they either give you staph or salmonella but never both of them! That's what i like about these tests! They maintain their standard!
According to 2015 FA, assume S aureus (most common overall cause) if no other information is available. For SCD it's both Salmonella and S aureus.
 
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