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Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with sickle cell disease are more susceptible to osteomyelitis and septic arthritis than the population at large. Seventy eight patients with these conditions were admitted to our hospital from April 1988 to March 1991. Thirty had sickle cell disease, 14 had the sickle cell trait and 34 had normal electrophoresis. The tibia, followed by the femur and humerus were the bones most commonly affected, and the knee was the joint most often involved. Salmonella was the commonest organism in osteomyelitis and septic arthritis in sickle cell disease, whereas staphylococcus was commonest in normal patients and those with the sickle cell trait. Antibiotics that cover these two organisms must be considered in patients with sickle cell disease who are suspected of having osteomyelitis or septic arthritis.
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PMID:Osteomyelitis and septic arthritis in sickle cell disease in the eastern province of Saudi Arabia. 147 97

We investigated 57 patients with sickle cell anaemia (HbSS) and bone and joint changes. Osteonecrosis simulating a wide range of conditions was a common radiological feature, and osteomyelitis occurred in 61% of cases. Salmonella species were the commonest causative organisms, occurring in 71% of patients with osteomyelitis, although salmonella septic arthritis occurred in only two. The distinction between vaso-occlusive bone crisis and acute osteomyelitis was often difficult since the classical clinical and radiological features and laboratory findings also occurred in bone infarction, a common feature of the disease.
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PMID:Bone and joint manifestations of sickle cell anaemia. 234 55

We report a prospective study of fourteen patients with sickle cell disease who were suffering from septic arthritis. They made up 11% of 129 patients with orthopaedic complications of the disease. The infecting organism in eleven was a staphylococcus, with salmonella in only two. The severity of the condition and its sequelae are described. The best treatment is open surgical drainage and intensive chemotherapy.
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PMID:Septic arthritis in sickle cell disease. 318 31

Osteonecrosis is not well documented as a predisposing factor of septic arthritis despite such a relationship having obvious clinical significance. We report 4 patients with involvement of 5 hips with septic arthritis in established osteonecrotic joints. The etiologies of the osteonecrosis in our study included corticosteroid therapy, sickle cell disease and one case of idiopathic osteonecrosis. Osteonecrosis appears to render the hip more susceptible to hematogenously derived bacterial infection. In some cases, removal of the necrotic tissue may be necessary to cure the infection.
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PMID:Acute septic arthritis in chronic osteonecrosis of the hip. 326 51

We studied retrospectively the pattern of septic arthritis in childhood at a major municipal hospital during a ten-year period. Hemophilus influenzae was the most common organism in septic arthritis in patients less than two years old and was associated with upper respiratory tract infections in nine of 12 patients (75%). Staphylococcus aureus was seen in seven of eight (87.5%) children above the age of five and was associated with history of trauma. All patients were black. Despite the high incidence of sickle cell disease in our hospital population, not one patient had sickle cell disease.
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PMID:Septic arthritis in childhood. 387 79

Streptococcus pneumoniae is the leading pathogen in children with sickle cell disease. Forty children younger than 20 years of age who had sickle cell disease and septicemia, meningitis, or osteomyelitis/septic arthritis were identified. The causes included Streptococcus pneumoniae (20%) and gram-negative organisms (mainly Salmonella) (70%). The gram-negative infections occurred in the first decade of life in 45% of our patients. We believe that this pattern of infection is different and related to the mild nature of sickle cell disease in our patients and to their persistent splenic function. The administration of pneumococcal vaccination may also have played a role. Microinfarcts of the intestinal wall allow the access of gram-negative organisms to the circulation. In places where gastrointestinal tract infections, especially Salmonella, are common, antibiotic therapy effective against these organisms is recommended initially with adjustment after identification and sensitivities are known.
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PMID:Pattern of bacterial infections in homozygous sickle cell disease. A report from Saudi Arabia. 402 63

To evaluate if the immune system is active in slipped capital femoral epiphysis (SCFE) or chondrolysis, 16 patients with SCFE were studied by evaluation of their serum immunoglobulins, histology of their synovium, and immunofluorescent staining of their synovium. Patients with Perthes' disease, chondromalacia patellae, septic arthritis, sickle cell disease, and torn meniscus were controls. Serum immunoglobulins were normal in all patients. The histology demonstrated synovitis in all patients except in one normal knee. Plasma cells were a prominent feature of the synovitis in the patients with SCFE. Three patients had positive synovial immunofluorescence for IgG and C3. Two of these patients subsequently developed chondrolysis and one did not. One additional patient who had negative synovial immunofluorescence developed chondrolysis. It is postulated that the immune system is active in some patients with SCFE, but what, if any, role it plays in the disease or its complications remains to be shown.
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PMID:Synovial immunofluorescence in patients with slipped capital femoral epiphysis. 704 51

The clinical features, pathogenesis, and results of conservative treatment of septic arthritis in 8 patients with sickle cell anemia (HbS) and one patient with HbS + C followed for an average of 2.8 years have been reviewed. All but one of the patients were children under 14 years of age. Hematogenous, symmetrical polyarticular arthritis predominated. The hip and the ankle were the joints most often affected. Clinically, the patients fell into 2 groups, namely, those with little or no systemic disturbance, in whom infection was localized to affected joints mainly; and critically ill patients in whom arthritis occurred later during the course of the illness. Gram-negative infection was dominant, and Salmonella was the most common organism cultured. There were no deaths, but the morbidity and complications were quite high. The sensitivity pattern of the bacteria isolated from this small series of patients suggests that a combination of gentamycin and cloxacillin possibly is the antibiotic combination of choice for the critically sick child with HbS complicated by polyarticular septic arthritis in West Africa, provided the child's renal function is adequate.
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PMID:The treatment of severely ill patients with sickle cell anemia and associated septic arthritis. 740 93

Fifty-seven Nigerian children with septic arthritis of the hip treated at the University College Hospital, Ibadan during the period of 1970-1975 were studied. Ages ranged between four weeks and thirteen years. The main presenting symptoms were painful swelling of the hip joint in 88% of patients while 70% had fever; and only five patients gave a history of trauma being associated. Twelve patients had dislocation of the affected hip; a discharging sinus was present in six patients. Staphylococcus aureus was the commonest organism associated with septic arthritis of the hip but salmonellae were found in sickle cell disease. Early management with aspiration of the affected hip, systemic antibiotics and wide abduction of both lower limbs gave good results.
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PMID:Presenting features of septic arthritis of the hip in Nigerian children. 742 3

Five children with pneumococcal bone and joint infections are described. Three of the children were less than one year of age and two had sickle cell disease. All but one had a primary or coincident focus of acute pneumococcal infection elsewhere. In the four children with septic arthritis, osteomyelitis was diagnosed subsequently in bones contiguous to the infected joint. All patients were successfully treated, although one developed permanent joint dysfunction. Although an unusual infection, pneumococcal infection of bones and joints should be sought in the appropriate clinical setting since such infection requires specific surgical therapy and may be associated with significant morbidity.
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PMID:Pneumococcal arthritis and osteomyelitis in children. 746 Apr 61


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