Childhood Osteomyelitis: a five-year analysis of patients with sickle cell anaemia in Port Harcourt, Nigeria

Osteomyelitis is an important cause of morbidity and mortality among sickle cell patients. The aim of this study was to determine the prevalence and pattern of osteomyelitis among children with sickle cell disease at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. This was a retrospective review of all the medical records of sickle cell patients below the age of sixteen years who were admitted into the Paediatric ward of the University of Port Harcourt Teaching Hospital, Port Harcourt from January 2003 to December 2007. Those with incomplete records were excluded. A total of 187 sickle cell patients were reviewed. Mean age of the study population was 6.95 +/- 4.23. There were more males [105] than females [82] giving a male female ratio of 1.3:1. Out of the 187 subjects with sickle cell anaemia 15 had osteomyelitis which accounted for a prevalence of 0.08%. Acute osteomyelitis accounted for 100% of cases. Klebsiela pneumonia was commonest organism isolated from blood culture 5 [33.3%]. Fever, leg swelling and bone pains were the commonest mode of presentation. The Tibia bone was commonly involved 8 [53.3%].The aetiological organisms were sensitive to ceftazidine and gentamycin in 55% of the positive blood cultures. The preponderance of Klebsiella pneumonia indicates a change in the previously accepted pattern of infection in which Salmonella species were considered to be the main causative organism