Osteomielite em Pacientes com Doença Falciforme

Abstract

Objective: identify clinical and laboratory characteristics of osteomyelitis (OM) in 3 patients with sickle cell disease (SCD). Metodology: Retrospective evaluation of medical records of a tertiary University Hospital in São Paulo. Discussion: The cases described were comparable to Weisman, 2020, regarding age and the higher frequency of involvement of long bones, and 2 of the 3 patients are homozygous for SCD. The three patients had leukocytosis similar to those found in the literature (Fontalis et al, 2019), and all showed an increase in CRP as the OM progressed, showing reduction in values ??when treatment started. Pain and local edema were present in the reported cases, and two of them presented pain in different sites, being diagnosed in these cases. In this study, no agent was isolated in blood cultures, as reported by Fontalis 2019. In case 1, the imaging exam showed expected changes, while in cases 2 and 3, the patients had involvement of long bones, the most common sites of previous bone infarction, acute and chronic alterations were found (Al Farii et al., 2020). Conclusion: SCD patients are at increased risk for osteomyelitis. The differential diagnosis between bone infarction related to vaso-occlusive crisis is a challenge, as the initial clinical presentation is similar. Osteomyelitis should be suspected in patients with SCD who present a vaso-occlusive crisis in only one site, with prolonged fever and an increase in inflammatory evidence. Early antibiotic therapy directed at the most frequent agents can avoid complications and allow for better prognosis.