II. Pathophysiology

  1. Infection of infarcted bone, especially long bones (multiple sites in same bone may be involved)

III. Causes

  1. Salmonella
    1. Most common organism in Sickle Cell AnemiaOsteomyelitis
  2. Staphylococcal Aureus (<25% of cases)

IV. Signs

  1. Fever
    1. Fever duration directly correlates with likelihood of Osteomyelitis (risk increases 80% each day of fever)
  2. Extremity swelling
    1. Osteomyelitis likelihood increases 8.4 fold
  3. Bone pain
    1. Osteomyelitis likelihood increases 20% each day of pain

V. Diagnosis

  1. Bone Culture

VI. Labs

VII. Imaging

  1. See Osteomyelitis
  2. Interpretation may be difficult in Sickle Cell Anemia as bone infarcts may appear similar to Osteomyelitis

VIII. Management

  1. Welsh and Welsh (2016) Crit Dec Emerg Med 30(11): 15-23

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