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What is the most common musculoskeletal infectious problem seen in SCD?
Osteomyelitis is seen more than 100 times more frequently in SCD than in normal individuals. It is frequently multifocal. Because of functional asplenia, Salmonella infections account for 50% of osteomyelitis especially in children with SCD. Fortunately, septic arthritis is infrequent but is usually caused by S. aureus or a gram-negative organism other than Salmonella when it occurs. The large proportion of gram-negative infections may be as a result of bacterial translocation across bowel mucosa that has been compromised by microinfarcts from sickling cells
Factors Predisposing Sickle Cell Patients to Infection
| Functional asplenia with decreased clearance of bacteriaTissue damaged by crisisDecreased neutrophil function at lower oxygen tensions | Decreased opsonizationDecreased interferon-γ productionIncreased risk of nosocomial infection |
