Hematology and Oncology Book

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Osteomyelitis in Sickle Cell Anemia

Aka: Osteomyelitis in Sickle Cell Anemia
  1. See Also
    1. Osteomyelitis
    2. Sickle Cell Anemia
    3. Transient Red Cell Aplasia
    4. Acute Chest Syndrome
    5. Acute Vaso-Occlusive Episode in Sickle Cell Anemia
    6. Aplastic Crisis in Sickle Cell Anemia
    7. Cerebrovascular Accident in Sickle Cell Anemia
    8. Dactylitis in Sickle Cell Anemia (Hand Foot Syndrome in Sickle Cell Anemia)
    9. Hematuria in Sickle Cell Anemia
    10. Priapism in Sickle Cell Anemia
    11. Pulmonary Hypertension in Sickle Cell Anemia
    12. Septic Arthritis in Sickle Cell Anemia
    13. Sickle Cell Anemia Related Pulmonary Hypertension
    14. Sickle Cell Anemia with Splenic Sequestration
  2. Pathophysiology
    1. Infection of infarcted bone, especially long bones (multiple sites in same bone may be involved)
  3. Causes
    1. Salmonella
      1. Most common organism in Sickle Cell AnemiaOsteomyelitis
    2. Staphylococcal Aureus (<25% of cases)
  4. Signs
    1. Fever
      1. Fever duration directly correlates with likelihood of Osteomyelitis (risk increases 80% each day of fever)
    2. Extremity swelling
      1. Osteomyelitis likelihood increases 8.4 fold
    3. Bone pain
      1. Osteomyelitis likelihood increases 20% each day of pain
  5. Diagnosis
    1. Bone Culture
  6. Labs
    1. Blood Cultures
      1. Test Sensitivity: 30 to 76%
  7. Imaging
    1. See Osteomyelitis
    2. Interpretation may be difficult in Sickle Cell Anemia as bone infarcts may appear similar to Osteomyelitis
  8. Management
    1. See Osteomyelitis
  9. References
    1. Lowe and Wang (2018) Crit Dec Emerg Med 32(11): 17-25
    2. Welsh and Welsh (2016) Crit Dec Emerg Med 30(11): 15-23

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