Patterns of Infections among Patients With Sickle-cell Anaemia requiring Hospital Admission

Abstract

Summary: Twenty-nine females and 28 males with sickle-cell anaemia were studied to ascertain what infections precipitated crisis. Clinical diagnoses were bone pain crisis (26), osteomyelitis (13), pneumonia (8), abdominal crisis (4), meningitis (3), pharyngitis (2) and cystitis (1). Twenty-one (37%) had Plasmodium falciparum, associated predominantly with bone pain, although all were supposedly receiving prophylactic antimalarials. Pathogenic bacteria were isolated in 27 (47%). Salmonellae were isolated from pus of 8 with osteomyelitis (7 having bacteraemia) and from blood of 2 with bone pain. Other isolates from blood or pus of patients with osteomyelitis or bone pain were Staphylococcus pyogenes (5) and Kleb siella (2). Streptococcus pneumoniae was grown from the blood of all and from sputum of 7 of 8 with pneumonia. Strept. haemolyticus was isolated from the throats of both with pharyngitis and Escherichia coli from the urine of the patient with cystitis. No organisms were identified in 12 (21%) of the patients.