[Salmonella osteomyelitis in a child with sickle cell disease]. / Salmonella-osteomyelitis bij een patiëntje met sikkelcelanemie.

In an eight-months-old girl with sickle cell disease, osteomyelitis due to Salmonella arizona was diagnosed. Osteomyelitis caused by Salmonella species is rare in children. However, in patients with sickle cell disease it is the responsible pathogen in more than 50% of cases. The differentiation between, the much more common, bone crisis and osteomyelitis in sickle cell patients is often difficult. Ultrasound and bone marrow scans may be helpful. It is not known why Salmonella causes osteomyelitis in patients with sickle cell disease. What is clear, however, is that osteomyelitis usually occurs shortly after a preceding bone crisis. Empiric antibiotic treatment of osteomyelitis in patients with sickle cell disease should include coverage for Salmonella species. The patient described was initially treated with cefuroxime and gentamicin, but once the culture result was known this was switched to amoxicillin. As new infection foci later occurred in the bone the treatment was switched to ceftriaxone i.v. which was later substituted by ciprofloxacin orally. With this all of the skeletal abnormalities were fully corrected.

Effect of cytokines on anticryptococcal activity of human microglial cells.

The effect of selected cytokines on the antifungal activity of human microglia was studied with encapsulated and acapsular strains of Cryptococcus neoformans. None of the cytokines tested increased the fungistatic activity of microglia, suggesting that killing of cryptococci within the central nervous system is dependent on other host defense mechanisms.