TITLE:
Osteomyelitis in Children with Sickle Cell Disease: A Challenging Diagnosis: Case Report from Cameroon
AUTHORS:
Djike Puepi Fokam Yolande, Kukwah Anthony Tufong, Tagakou Mboula Jules, Andang Paul Mayah, Eposse Ekoube Charlotte, Diomede Noukeu Njinkui, Dominique Enyama, Helene Kamo Selangai, Verla Vincent Siysi
KEYWORDS:
Chronic Osteomyelitis, Sickle Cell Disease, Child
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.2,
May
31,
2021
ABSTRACT: Introduction:Sickle Cell Disease (SCD) is the most prevalent
genetic disease in the world predominantly in the African population with
Sickle Cell Anaemia (SCA) being its dominant form. One of the most frequent
complications of SCD
is osteomyelitis. SCA is due to a point mutation in the beta globin chain of haemoglobin. This is responsible for the sickled shape of
RBCs under low oxygen tension conditions leading to obstruction in the
microcirculation. This leads to vaso-occlusive crises (VOC) which has a similar
clinical presentation to that of osteomyelitis, another complication of SCD. Case Presentation: We present the case of a three-year-old girl with SCA who presented with
an inability to bear weight in a febrile context. A diagnosis of VOC was
initially made, which was later on changed to both a left chronic tibial and
right distal femoral osteomyelitis following a series of biological, and
imaging investigations. Surgical debridement and drainage were performed,
resulting 9 weeks later in the involution of fever and leg pain. Conclusion: Osteomyelitis when associated with SCD is a dreadful
and deathly disease in low income countries as it also presents like VOC
therefore higher suspicion index is recommended. It is therefore important to
take this into consideration at an early stage in patients with homozygous
sickle cell disease so as to rapidly initiate multidisciplinary care. Appropriate
investigations, appropriate antibiotic therapy, and timely surgical
intervention would
help to greatly reduce morbidity and mortality.