Question

A boy presented with multiple non suppurative osteomyelitis with sickle cell anaemia. What will be the causative organism ?

• A. Salmonella
• B. S. aureus
• C. H. influenzae
• D. Enterobacter species

Answer 1

The Correct Option is A

In patients with sickle cell anemia, the most common causative organism of osteomyelitis is Salmonella. Sickle cell anemia causes a compromised immune state and specific alterations in the circulatory system that make these patients more susceptible to infections by this pathogen. While S. aureus is a common cause of osteomyelitis in the general population, Salmonella is notably prevalent in individuals with sickle cell anemia.

To understand why Salmonella is the correct answer in this context, let's review some key points:

• Sickle cell anemia leads to functional asplenia and increased susceptibility to encapsulated bacteria.
• Salmonella species are known to cause bloodstream infections and subsequently seed the bones, leading to osteomyelitis, especially in the setting of hemoglobinopathies such as sickle cell anemia.
• The mechanism involves infarctions in the bone and marrow, caused by vaso-occlusive episodes, which facilitate infection by circulating Salmonella.

Thus, in the setting of a boy with sickle cell anemia presenting with multiple non-suppurative osteomyelitis, considering the common pathogens, Salmonella is the most likely causative organism.