Salmonella epidural abscess in sickle cell disease: failure of the nonsurgical treatment.
In patients suffering from sickle cell disease (SCD), bone is a preferred site of infection. We report the case of a five-year-and-eight-month-old black African boy with homozygous-SS disease who developed a cranial epidural abscess. This intracranial infectious complication originated from a Salmonella enteritidis osteitis of the frontal bone. Antibiotic treatment alone did not control the disease, so surgery was necessary to remove the necrotic bone and to evacuate the epidural pus. The numerous factors interfering with normal healing of a septic focus in sickle cell anemia, particularly in this previously undescribed intracranial complication, emphasize the need for a primary and early surgical treatment in similar situations.
Diebold
Patrick
P
Service de Pédiatrie, Hôpital du Chablais, CH 1860 Aigle, Switzerland.
Humbert
James
J
Djientcheu
Vincent de Paul
Vde P
Gudinchet
François
F
Rilliet
Benedict
B
D000755:Anemia, Sickle Cell / Q000150:complications*; D000900:Anti-Bacterial Agents; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D020802:Epidural Abscess / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D005624:Frontal Bone; D006801:Humans; D008297:Male; D010000:Osteitis / Q000382:microbiology* / Q000601:surgery; D012480:Salmonella Infections / Q000188:drug therapy* / Q000601:surgery*; D012477:Salmonella enteritidis
D000900:Anti-Bacterial Agents