Summary
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.
Résumé
Les malades atteints de drépanocytose sont plus exposés aux ostéomyélites et aux arthrites septiques que les sujets normaux. En trois ans, d'Avril 1988 à Mars 1991, 78 malades ont été admis à l'hôpital central de Qatif pour ostéomyélite et/ou arthrite septique. Ils présentaient 66 localisations osseuses et 38 articulaires. Trente malades avaient une drépanocytose homozygote, quatorze une hémoglobinose hétérozygote et les autres une électrophorèse normale de l'hémoglobine. Chez les trente malades drépanocytaires, il y avait 32 localisations osseuses et 16 atteintes articulaires. Le tibia était la localisation la plus fréquente (43.9%) suivi par le fémur (21.2%) et par l'humérus (18.2%). Le genou était l'articulation la plus souvent atteinte par l'arthrite septique (58.8%). Les salmonelles étaient les bactéries les plus fréquemment en cause chez les malades drépanocytaires (homozygotes), tandis que les staphylocoques dorés étaient plus communément retrouvés chez les malades hétérozygotes et chez les sujets normaux. Les antibiotiques efficaces à la fois vis-à-vis des salmonelles et des staphylocoques dorés doivent être utilisés chez les malades atteints de drépanocytose ou d'hémoglobinose hétérozygote chaque fois qu'existe une suspicion d'ostéomyélite et/ou d'arthrite septique.
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Al-Salem, A.H., Ahmed, H.A., Qaisaruddin, S. et al. Osteomyelitis and septic arthritis in sickle cell disease in the eastern province of Saudi Arabia. International Orthopaedics 16, 398–402 (1992). https://doi.org/10.1007/BF00189627
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DOI: https://doi.org/10.1007/BF00189627