A 9-year-old boy with homozygous sickle cell disease presents with fever and bone pain. Which organism is classically associated with osteomyelitis in this patient?

• A Mycobacterium tuberculosis
• B Pseudomonas aeruginosa
• C Streptococcus pneumoniae
• D Salmonella species ✓

Explanation

Salmonella osteomyelitis is the classical association with sickle cell disease, thought to follow intestinal microinfarction allowing Salmonella bacteraemia to seed infarcted bone. Note that Staphylococcus aureus remains the single most common organism even in sickle patients, so empiric therapy covers both, but Salmonella is the characteristic examined association. Pseudomonas is linked to puncture wounds of the foot, not sickle disease.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.