Wright, T.; Thomas, Peter W.; Serjeant, Graham R.
Author Affiliation, Ana.
Medical Research Council Laboratories (Sickle Cell)
Septicemia caused by Salmonella infection: An overlooked complication of sickle cell disease.
Journal of Pediatrics
Date of Publication
Study aims to describe the characteristics of salmonella infections in sickle cell disease and to compare the features of osteomyelitis and those with bacteremia/septicemia without obvious bone changes, to search for risk factors for osteomyelitis, and to draw attention to the frequency and significance of salmonella bacteremia/septicemia. The study design was a retrospective review of all salmonella isolations from the blood, pus, or aspirates during a 22-year period at the sickle cell clinic at the University Hospital of the West Indies, Kingston, Jamaica. Patients with all genotypes of sickle cell diseases. Incidence data and the frequency of associated cholelithiasis were derived for the cohort study based on follow-up of all children detected by neonatal screening. Of 55 patients with salmonella infections, 25 initially had osteomyelitis and 27 had bacteremia/septicemia. Three of the first group later had bacteremias for a total of 30 episodes of bacteremia/septicemia, and 4 of the second group later had osteomyelitis for a total of 32 episodes of osteomyelitis. The incidence of salmonella infection was 8.6 percent by 15 years and 96 percent of infections occurred before the age of 10 years. Preceding episodes of avascular necrosis of bone were frequent (p 0.006) in patients with osteomyelitis. Patients with osteomyelitis were not more prone to gallstones. High fever.....