title: Osteomyelitis and pyomyositis due to Pseudomonas aeruginosa in a child with sickle β⁰-thalassemia.
abstract: Sickle cell osteomyelitis is usually due to Salmonella or Staphylococcal etiology. Pseudomonas as a cause of sickle cell osteomyelitis is rare. Similarly, pyomyositis is a rare complication in children with sickle cell disease and few cases have been reported, predominantly due to Staphylococcus. We describe an 8-year-old boy who presented with high-grade fever and tender, swollen left thigh. There was a history of intramuscular injections in the left thigh. He also had severe anemia, hepatosplenomegaly, and laboratory evidence of hemolysis. Hemoglobin electrophoresis showed sickle β-thalassemia. Magnetic resonance imaging of the left thigh showed evidence of osteomyelitis with pyomyositis. Surgical drainage of the pus was done and Pseudomonas aeruginosa was isolated. He was treated with intravenous antibiotics for 8 weeks. The child had a protracted course of illness with development of pathologic fracture of the femur. Clinicians need to be aware of Pseudomonas infection as a complication in children with sickle cell disease, as this affects therapeutic decisions, including the choice of antibiotics.
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Sriram
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Thimmaiah
authors.forename: Ananthakrishnan
authors.initials: A
authors.lastname: Ramesh
authors.forename: Niranjan
authors.initials: N
authors.lastname: Biswal
authors.forename: Jagdish
authors.initials: J
authors.lastname: Menon
authors.forename: Sundarajan
authors.initials: S
authors.lastname: Elangovan
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D011379:Prognosis; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D052880:Pyomyositis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013789:Thalassemia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents