insight
Forum Junior
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What is the most common causative organism of osteomyelitis in a sickle cell patient?
A) Staph aureus
B) Salmonella
There is some confusion about the correct answer
Please, provide the reference if you know the answer. Thanks in Advance.
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| hitesh
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Topics: 64
Posts: 1,075
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I always thought it was salmonella..
Where did you find a discrepancy? 
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12/28
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| insight
Forum Junior
Topics: 13
Posts: 36
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Some says that staph.a is generally the mcc of osteomyelitis.
and Salmonella osteomyelitis is mostly seen in sickle cell patients.
did u notice the difference ?
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| hitesh
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Topics: 64
Posts: 1,075
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I am still not getting you..
Staph aureus is the MCC of Osteomyelitis overall (i.e. in general population)
In patients with sickle cell anemia, Salmonella is the MCC of it..
Where is the confusion?
If your question is (the other way round) what population is affected most by salmonella osteomyelitis.. well, the answer should again be scikle cell anemia patients.. But i'm not sure and I wonder how important this fact would be clinically... The only importance would be if a sickle cell anemia patient presents for the first time with salmonella osteomyelitis and this helps you diagnose his Sickle cell disease..( It's an unlikely scenario)
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12/28
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| ngaybinhyen
Forum Guru
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I think most common = Staph
But Sickle disease in crease risk of Sammonella
I'll look for the source and post later
Here is the source:
Staphylococcal species are, as in the general population, the most common organisms isolated, but there is a higher incidence of infection with intestinal flora such as Salmonella, Enterobacter, and Escherichia coli
(Conn's Current Therapy 2008)
Osteomyelitis is usually caused by staphylococcal infection, but salmonella infection ( Chapter 329 ) is a particular cause of sickle cell osteomyelitis
(Cecil Medicine, 2007)
Although I found out others say Salmonella is the MMC of osteomyelitis in Sickle cell disease (up to 50%) but believe Staph is more common in genaral. Correct?
-t.
Edited by ngaybinhyen on 09/05/08 - 10:27 AM
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| insight
Forum Junior
Topics: 13
Posts: 36
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Great post.
Thanks ngaybinhyen.
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| sucralfate
Forum Senior
Topics: 14
Posts: 74
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I think S. aureus is the most common cause of osteomyelitis both in the general population and sickle cell disease.
Sickle cell disease patients have an increased risk of Salmonella infections but S. aureus remains the MCC.
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| ngaybinhyen
Forum Guru
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Posts: 657
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| hitesh
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Topics: 64
Posts: 1,075
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This is interesting .. thank you for bringing this up.. there seems to be quite a controversy over this and different studies have shown different results..
here's what i found out :
http://pediatrics.aappublications.org/cgi/content...
A controversy that arises is whether S aureus is the most common cause of infection in these children overall, or does Salmonella actually predominate. The authors of the chapter on [font style=]osteomyelitis[/font] and septic arthritis in the current edition of a major pediatric text state that "Salmonella [font style="background: #ffffff; color: #cc0000" color="#cc0000"]osteomyelitis[/font] tends to occur more often in children with hemoglobinopathies, although even in this group, S aureus remains the predominant pathogen."1 The authors of the chapter on [font style="background: #ffffff; color: #cc0000" color="#cc0000"]osteomyelitis[/font] and septic arthritis in the current edition of a major pediatric infectious diseases text state that "seventy percent of all lesions or blood cultures in children with hemoglobinopathies and presumed [font style="background: #ffffff; color: #cc0000" color="#cc0000"]osteomyelitis[/font] yield Salmonella microorganisms, 10% contain S aureus, and aerobic Gram-negative rods are isolated in 7%."2
AND
http://www.ejbjs.org/cgi/content/abstract/73/9/12...
Although Salmonella has been cited as the principal causative organism of [font style=]osteomyelitis[/font] in patients who have [font style="background: #ffffff; color: #cc0000" color="#cc0000"]sickle[/font]-[font style="background: #ffffff; color: #cc0000" color="#cc0000"]cell[/font] disease, in our experience Staphylococcus aureus was the most common infecting organism. Therefore, Salmonella may not be the most common cause
But I'm pretty sure I have come accross the same question (in either UW or somewhere else, not sure) and salmonella was the right answer.. So, as far as the exam is concerned, if see the same question on CK (But now i really hope that dont), i think i am gonna go with salmonella.
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12/28
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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Everybody, please post your experience with UW or Kaplan Qbank
Many thanks
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| DrAlex_76
Forum Guru
Topics: 120
Posts: 410
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Stap still the one
Salmo is more likely in SCD.
If the Q comes up with 2 options, go for Staph , Salmo is the tricky one which they want us to pick.
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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You're the man, Dr_Alex. Good luck and "bao trong!"
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| nightflight1945
banned
Topics: 32
Posts: 920
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In UW it is said Salmonella
In Kaplan it is said Staph
However it is no big deal , because it is different in different studies and as long as it is controversy , you will not see both answers in the real exam
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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thanks for your sharing, nightflight
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