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首页> 外文期刊>The East African medical journal >Chronic osteomyelitis in patients with sickle cell disease.
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Chronic osteomyelitis in patients with sickle cell disease.

机译：镰状细胞病患者的慢性骨髓炎。

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OBJECTIVE: To determine the baseline pattern and audit management modalities of chronic osteomyelitis in patients with sickle cell disease. DESIGN: A retrospective study. SETTING: Jos University Teaching Hospital, Jos, Nigeria from August 1993 to July 1997. PATIENTS: Twenty four patients with concomitant chronic sickle cell disease. INTERVENTIONS: Fifteen patients had operations; eleven had sequestrectomy and curettage while four had incision and drainage. Eight patients were treated with antibiotics alone and one patient refused surgery. MAIN OUTCOME MEASURES: The demographic data of patients, aetiological agents, culture and sensitivity patterns, aetiopathogenesis, treatment modalities and outcome were analysed. RESULTS: Twenty four (36.9%) out of 65 patients who had chronic osteomyelitis also had sickle cell disease. Male:female ratio was 1.2:1. The peak age incidence (37.5%) was in the first decade of life. Seventy five per cent of infections were haematogenous. The most frequently isolated organism was Staphylococcus aureus (58.8%) while the rest were Gram negative organisms. There was no case of Salmonella osteomyelitis. The most sensitive antibiotics were gentamicin and the third generation cephalosporins. Twelve patients (50%) had good results while eight (33.3%) were still undergoing treatment. Complications recorded were persistent discharging sinuses in two cases, recurrence of symptoms in one and pathological fracture with non-union in one patient. CONCLUSION: Though the incidence of Gram negative organisms in causation of chronic osteomyelitis in patients who have sickle cell disease is high (41.2%), Salmonella osteomyelitis may be related to endemicity of the organism in a given locality.
机译：目的：确定镰状细胞病患者的慢性骨髓炎的基线模式和审计管理方式。设计：一项回顾性研究。地点：1993年8月至1997年7月在尼日利亚乔斯的乔斯大学教学医院。患者：24例伴有慢性镰状细胞病的患者。干预：15例患者接受了手术。 11例进行了脊柱切除术和刮除术，4例进行了切口引流术。八名患者仅接受抗生素治疗，一名患者拒绝手术。主要观察指标：分析患者的人口统计资料，病因，文化和敏感性模式，病因，治疗方式和预后。结果：在患有慢性骨髓炎的65名患者中，有24名（36.9％）也患有镰状细胞病。男女之比为1.2：1。年龄的最高发病率（37.5％）在生命的前十年。百分之七十五的感染是血源性的。最常分离的生物是金黄色葡萄球菌（58.8％），其余是革兰氏阴性生物。没有沙门氏菌骨髓炎的病例。最敏感的抗生素是庆大霉素和第三代头孢菌素。 12名患者（50％）取得了良好的效果，而8名（33.3％）仍在接受治疗。记录的并发症为持续性鼻窦炎2例，症状复发1例，病理性骨折伴不愈合1例。结论：尽管在镰状细胞病患者中革兰氏阴性菌引起慢性骨髓炎的发生率很高（41.2％），但沙门氏菌骨髓炎可能与特定地区的该菌的流行有关。

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