DrVirgo
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What is the most common cause of Osteomyelitis in Sickle Cell Disease?
Salmonella, correct?
Which type?
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| doc179
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it is salmonella...do not know the type
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| DrVirgo
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anyone know???
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| general malaise
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salmonella cholerasius....which is the most salmonella causing septicemia in these pts
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| doc179
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general malaise are you sure abt this cos I think goljan said in his audio that its salmonella murium
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| general malaise
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yes, but goljan also says in his rapid review that its caused by salmonella paratyphyi. it seems like he can't decide. so i looked in levinson's and basically there are the typhoid species and the non-typhoid species. the non-typhoids are related to other clinical scenarios like septicemia which occurs in debilitated pts and those with sickle cell anemia. septicemia is most often caused by S. cholerasius so i thinks its safe to assume its also the cause for osteomyelitis in sickle anemia. i think this is a question only a microbiologist can answer
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| ramo7
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amen to that...
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| DrVirgo
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Actually, I found that in Goljan High Yield,
He says:
"Osteomyelitis in HbSS: Staphylococcus aureus still more common than Salmonella"
so now i'm even more confused.
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| tolito
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The general saying is that the most common cause of osteomyelitis even in HBSS is staphylococcus aureus. the incidence of salmonella spp caused osteomyelitis is however highest amongst HBSS.
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| bactitech
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This may be the textbook answer, but I see TONS more Staph. infections in all patients than Salmonella. Most of the Salmonella we get are from fecal specimens and are not systemic. So, while that is probably a test question that you must know, in the real world, you will encounter Staph. infections MUCH more often. That being said, if your patient is a sickler, you must be aware of this possibility.
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| nadiabarati
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but textbooks are written based on real world and they aren't imaginary!
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| DrVirgo
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Tolito and Bactitich are right...
So to sum it up:
Both Staph aureus and Salmonella can cause Osteomyelitis.
Staph is still the most common cause of Osteomyelitis in ALL patients.
However when Salmonella causes Osteomyelitis, its more common in patients with Sickle Cell rather than the general population...
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| tolito
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correct drvirgo
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| enthu
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agree to drvirgo
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