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A Comparison of Chronic Osteomyelitis in Sickle Cell Disease and Non-Sickle Cell Disease Patients
Abstract
Background: Osteomyelitis in Sickle Cell Disease (SCD) and non-SCD patients has different clinical pictures. This study was designed to compare the pattern of chronic osteomyelitis in these two populations.
Method: This is a prospective study in which 30 Consecutive
SCD patients with chronic osteomyelitis of haematogenous origin
(SO) and 30 consecutive non-SCD patients with chronic osteomyelitis of haematogenous origin (NO) were compared between November 2003 and March 2005.
Result: The presenting complaints were similar in both groups except for a higher incidence of bone pain among SCD patients. There was a significantly higher incidence of multifocalization (p =0.02), bilaterality (p = 0.01) and symmetry (p = 0.01) among SCD patients. SCD patients had significantly higher leucocyte count (p<0.01). Staphylococcus aureus was the most common pathogen among the two groups of patients; 69.0% in the SO and 82.1% in the NO . Even though the proportion of gram negative pathogens isolated from SO (41.4%) were more than those from NO (39.3%) the difference was not significant. Salmonella was not isolated in any of the groups.
Conclusion: Bone pain, upper limb involvement and leucocytosis are more common manifestations of chronic osteomyelitis in SCD patients than in the non-SCD patients. Staphylococcus aureus remains the most common pathogen of chronic osteomyelitis in both groups in our environment.While gram negative organisms are prominent aetiologic factors; Salmonella organisms were not cultured in any of the patients. Hence, antibiotics effective against Staphylococcus aureus and gram negative organism should be prescribed.
Method: This is a prospective study in which 30 Consecutive
SCD patients with chronic osteomyelitis of haematogenous origin
(SO) and 30 consecutive non-SCD patients with chronic osteomyelitis of haematogenous origin (NO) were compared between November 2003 and March 2005.
Result: The presenting complaints were similar in both groups except for a higher incidence of bone pain among SCD patients. There was a significantly higher incidence of multifocalization (p =0.02), bilaterality (p = 0.01) and symmetry (p = 0.01) among SCD patients. SCD patients had significantly higher leucocyte count (p<0.01). Staphylococcus aureus was the most common pathogen among the two groups of patients; 69.0% in the SO and 82.1% in the NO . Even though the proportion of gram negative pathogens isolated from SO (41.4%) were more than those from NO (39.3%) the difference was not significant. Salmonella was not isolated in any of the groups.
Conclusion: Bone pain, upper limb involvement and leucocytosis are more common manifestations of chronic osteomyelitis in SCD patients than in the non-SCD patients. Staphylococcus aureus remains the most common pathogen of chronic osteomyelitis in both groups in our environment.While gram negative organisms are prominent aetiologic factors; Salmonella organisms were not cultured in any of the patients. Hence, antibiotics effective against Staphylococcus aureus and gram negative organism should be prescribed.
