Salmonella epidural abscess in sickle cell disease: Failure of the nonsurgical treatment

• Published in: Journal of the National Medical Association Vol. 95; no. 11; pp. 1095 - 1098
• Main Authors: DIEBOLD, Patrick, HUMBERT, James, DE PAUL DJIENTCHEU, Vincent, GUDINCHET, Francois, RILLIET, Benedict
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01-11-2003; Elsevier Limited; National Medical Association
• Subjects: Anemia, Sickle Cell - complications; Anemias. Hemoglobinopathies; Anti-Bacterial Agents; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Child, Preschool; Diseases of red blood cells; Drug Therapy, Combination - therapeutic use; Epidural Abscess - drug therapy; Epidural Abscess - microbiology; Epidural Abscess - surgery; Frontal Bone; General aspects; Hematologic and hematopoietic diseases; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Osteitis - microbiology; Osteitis - surgery; Salmonella; Salmonella enteritidis; Salmonella Infections - drug therapy; Salmonella Infections - surgery; Hemoglobinopathy; Salmonella; Sickle cell anemia; Abscess; Hemopathy; Genetic disease; sickle cell disease; Infection; Extradural; Salmonella infection; Hemolytic anemia; Treatment; cranial epidural abscess; Bacteriosis; Bacteria; Skull; Tropical medicine; Salmonellosis; Failure; Enterobacteriaceae
• ISSN: 0027-9684; 1943-4693

In patients suffering from sickle cell disease (SCD), bone is a preferred site of infection. We report the case of a five-year-and-eight-month-old black African boy with homozygous-SS disease who developed a cranial epidural abscess. This intracranial infectious complication originated from a Salmonella enteritidis osteitis of the frontal bone. Antibiotic treatment alone did not control the disease, so surgery was necessary to remove the necrotic bone and to evacuate the epidural pus. The numerous factors interfering with normal healing of a septic focus in sickle cell anemia, particularly in this previously undescribed intracranial complication, emphasize the need for a primary and early surgical treatment in similar situations.