ujaala
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what is the most common cause of osteomyelitis in sickle cell patiens?
acc to kaplan , its S. Aureus
acc to USMLE world its salmonella...
whats true?
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| docarchana
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it is S.aureus.
Salmonella osteomyelitis occurs in sickle cell pts.
But out of staph and salm, staph is more common
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| Sea_gull
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Overall most common cause of osteomyelitis = Staph aureus
MCC of osteomyelitis in SCA patients = Salmonella
GL
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| docswapna
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no seagull. even in sickle cell pts, staph is the most common.
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| ujaala
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you see, this is the problem...
kaplan is sayin its staff...but when i was doing usmleworld mcqs i came across a ques , in which they said that salmonella is the m.c cause in osteomyelitis..they further said tht sum bks say its staff...but tht is wrong...now which source shall we follow? 
p.s: there r many things in which kaplan is sayin one thing n usmle world the other...i wonder wht ppl making mcqs for the exam wud follow...
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| MDcooper
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from step 1 I rememeber,salmonella is the MCC of osteomyelitis in sickle cell but step 2 says the most common stays the same as for pneumonia most common is strept pneumonia no matter in communithy aquired,in alchoholic in immuno compromised.....same way most common cause of osteo myelitis is staph aureus.It is kind of contradicting but for boards sake,answer staph aureus..
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| Sea_gull
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docswapna wrote:
no seagull. even in sickle cell pts, staph is the most common.
Harrison Edition 16th page 2059
"Patients with sickle cell disease may also develop ostomyelitis, which commonly involves the long tubular bones.These patient are particularly susceptible to bacterial infections , especially Salmonella inffections , which are found in more than half of cases "
Best of luck
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| study_ing
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in the explanation for the UW question which was mentioned, they infact said that some sources talk about s aureus to be the more common and salmonella to be more likely. however they emphasized that salmoinella was in fact more common and had given references of studies to back it up.
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| tolito
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it is a funny world we live in!!! in africa where we have a worse infection and sickle cell burden, i never treated a single sickler with salmonella. they all had staph. our books and research teach us it is staph.
step 1 said it was salmonella, step 2 says it is staph. uw says it is salmonella. i will put my money on kaplan. uw gave only ONE source.
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| study_ing
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actually kaplan was better than uw..i somehow trust them more. in terms of explanations etc i think they do a better job. ok ill shift my vote to staph. thanks tolito
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| study_ing
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if only theyd have cheaper q banks!!
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| Sea_gull
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study_ing wrote:
actually kaplan was better than uw..i somehow trust them more. in terms of explanations etc i think they do a better job. ok ill shift my vote to staph. thanks tolito
I have already given the reference of Harrison now come others
- Current consult 2005 page 698: Under osteomyelitis it says "In sickle cell anemia ,Salmonella is the most common pathogen"
- Conn's Current therapy 2006 ,page 500:"Nearly three quarters of cases of osteomyelitis with sickle cell disease are attributed to Salmonella specie.
- Cecil Textbook of medicine .Edition 22nd page 1034 : "Osetomyelitis occurs more commonly in sickle cell disease , probably as result of infection of infarcted bone .Among sickle cell patients , osteomyelitis is commonly caused by Salmonellla species. S.aureus accounts for less than 25% of cases.
Best of luck
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| study_ing
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and harrison's too right..thanx sea-gull
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| tolito
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thanks seagull.
the salmonella vs staph war still rages wild after so many decades!!!!
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| Sea_gull
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tolito wrote:
thanks seagull.
the salmonella vs staph war still rages wild after so many decades!!!!
Welcome
Actually this is just our way of thinking
Best of luck
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| star1
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Salmonella causes osteomyelitis in sickle cell Diseaae but not in Sicke cell TRAIT
so we can say that in sickle cell trait MCC is still S. Aureus
GL
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| saadtazjam
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per gojlan step i path:salmonella cannot get filtered due to dysfunctional spleen(defective macrophages) present in sickle cell .hence it is number one cause next in line is staph aureus:
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| study_ing
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staph aureus for sickle cell trait..hmm and who was it, kaplan or UW ?
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| cbenitesch
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nice review! Thanks
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