Hy 2436 Since this high yield factoid came up a dozen posts ago, I’ll repeat it…

[tommyk]

Hy 2436 Since this high yield factoid came up a dozen posts ago, I’ll repeat it…
Say a 10-year-old boy named Jim Carrey comes to your Eternal Sunshine of the Spotless Mind Clinic in Chicago, IL with sickle cell disease presents with left leg pain and a high fever. He has been refusing to walk. Labs show signs of bacterial infection. His left femur is tender, and there is marked soft tissue swelling. A plain film of his left leg is normal. A bone scan shows increased uptake around the metaphysis of the left femur. Which of the following is the most likely bug? What is the disease?
1-H. flu
2-Staph. Aureus
3-Salmonella
4-group A B-hemolytic Strep
5-Strep pneumo



























































































a) I still truly think the correct answer is S. aureus in this age group for OSTEOMYELITIS, even though a lot of buzzword books “suggest” Salmonella (as a common associated “match word”). Although I agree that Salmonella is greatly increased in pts. W/ sickle cell, the most common OVERALL is still S. aureus. Be careful because boards love to use this as a rather unfair trick. Again, Staphylococcus aureus is the most common pathogen, with group A beta-hemolytic streptococci a distant second. Neonates are at risk for group B beta-hemolytic streptococci. Haemophilus influenzae may occur in infants and young children, but it is not seen as frequently as in septic arthritis. In addition, children with H. influenzae osteomyelitis usually have fever and concomitant joint infection. Patients with puncture wounds of the foot are susceptible to Pseudomonas aeruginosa osteomyelitis. If anyone finds any DEFINITE proof in a legitimate respected source, let me know and cite the source please…

sickle cell disease are at risk for infection by Salmonella and other gram-negative bacteria, and patients in the 18- to 48-month age range are at increased risk for acute recurrent Salmonella osteomyelitis. Salmonella osteomyelitis frequently involves multiple sites and creates punched-out destructive lesions of the metaphysis and diaphysis. However, even in patients with sickle cell disease, Staphylococcus aureus is still the most common pathogen for osteomyelitis