In children with sickle cell disease, what organisms are primarily responsible for osteomyelitis?

In children with sickle cell disease, the most common pathogens responsible for osteomyelitis are Salmonella and Staphylococcus aureus. This association is significant due to the specific immunological and hematological factors present in sickle cell disease.

Children with sickle cell disease have an increased risk of infections, particularly from encapsulated organisms and bone-related infections. The sickling of red blood cells can lead to vaso-occlusive events that compromise blood flow to the bone, creating an environment conducive to infection. Salmonella species are particularly notorious for causing osteomyelitis in these patients, as they can thrive in the compromised vascular and immune environment. Additionally, Staphylococcus aureus is a common organism responsible for both osteomyelitis and skin infections.

The combination of these bacteria aligns with the unique pathophysiology of sickle cell disease, making the presence of both Salmonella and Staphylococcus aureus crucial when considering the most likely pathogens involved in osteomyelitis among affected children. This understanding is essential for guiding appropriate antibiotic therapy and management in this vulnerable population.