In a 5-year-old with sickle cell anemia presenting with leg pain and fever, which organism should be covered when choosing antibiotics for suspected osteomyelitis?

In a 5-year-old with sickle cell anemia presenting with leg pain and fever, which organism should be covered when choosing antibiotics for suspected osteomyelitis?

• A. E. coli
• B. Salmonella
• C. Proteus species
• D. Helicobacter pylori

Answer: (B)

In the context of a 5-year-old patient with sickle cell anemia presenting with leg pain and fever, the most appropriate antibiotic coverage would be for Salmonella species. Children with sickle cell anemia are at increased risk for infection due to impaired splenic function and the sickling of red blood cells, which can cause vaso-occlusive crises leading to tissue ischemia and bone necrosis. Salmonella is particularly noteworthy because it is one of the most common pathogens associated with osteomyelitis in patients with sickle cell disease. The hypersplenism and splenic dysfunction commonly seen in these patients predispose them to certain encapsulated organisms; however, Salmonella stands out due to its association with osteomyelitis specifically in individuals with sickle cell anemia. While E. coli, Proteus species, and Helicobacter pylori may be significant pathogens in various contexts, they are not as strongly linked to osteomyelitis in this specific patient population. Therefore, focusing on Salmonella provides a targeted and effective approach to managing the risk of osteomyelitis in children with sickle cell disease.

In the context of a 5-year-old patient with sickle cell anemia presenting with leg pain and fever, the most appropriate antibiotic coverage would be for Salmonella species. Children with sickle cell anemia are at increased risk for infection due to impaired splenic function and the sickling of red blood cells, which can cause vaso-occlusive crises leading to tissue ischemia and bone necrosis.

Salmonella is particularly noteworthy because it is one of the most common pathogens associated with osteomyelitis in patients with sickle cell disease. The hypersplenism and splenic dysfunction commonly seen in these patients predispose them to certain encapsulated organisms; however, Salmonella stands out due to its association with osteomyelitis specifically in individuals with sickle cell anemia.

While E. coli, Proteus species, and Helicobacter pylori may be significant pathogens in various contexts, they are not as strongly linked to osteomyelitis in this specific patient population. Therefore, focusing on Salmonella provides a targeted and effective approach to managing the risk of osteomyelitis in children with sickle cell disease.