Patient’s History
• A 7-year-old girl was well until about 3 weeks
ago, when she began complaining of being
“tired all the time.”
• On exam, her temperature is 38°C and there is
tenderness below the right knee.
• Hemoglobin: 10.2; WBC: 9600 with increased
neutrophils.
• A sickle cell prep shows a moderate sickling
tendency.
• Gram negative rods grew in the blood culture.
DIAGNOSIS
• Osteomyelitis caused by Salmonella species
– Sickle cell anemia predisposes to osteomyelitis
caused by Salmonella species
– The abnormally shaped sickle cells are trapped in
the small capillaries of the bone and cause
microinfarcts.
– These microinfracts enhance the likelihood of
infection by Salmonella.