Abstract
Background: Among hemoglobinopathies, the most prevalent in our population are hemoglobins S and C, which are capable of producing disease when homozygous. In cases of double heterozygotes with sickle hemoglobin C (SC), the disease is less expressive in its clinical condition and rarer. Case report: Patient has a previous hospitalization with pain in the joints in knee and hip and several febrile peaks. Upon physical examination, the patient had difficulty in walking, without edema, pedal and tibial posterior pulses present, with no signs of compartment syndrome. Complementary exams revealed anemia, leukocytosis and lymphopenia. The hemoglobin electrophoresis showed the SC Hemoglobinopathy. The treatment with antibiotic therapy according to the protocol (Oxacillin and Ceftriaxone) was restarted and submitted to joint drainage in affected limb. Conclusion: Osteomyelitis and septic arthritis in patients in the pediatric age group should be considered as serious infections that deserve hospitalization and more expressive treatment.
Highlights
The treatment with antibiotic therapy according to the protocol (Oxacillin and Ceftriaxone) was restarted and submitted to joint drainage in affected limb
Sickle cell disease is a group of genetic diseases that is especially prevalent in tropical and subtropical regions [7] caused by inheritance of HBB mutations due to sickle hemoglobin (HbS mutation, HBB E6V) in homozygous form (Sickle Cell Anemia, HbSS) or as a composite heterozygote with another abnormal hemoglobin (e.g. HbSC, HbSβtalh) [8]
Forced migration and the continuous movement of the population have spread throughout the world, with birth rates estimated at 0.49 per 1000 in the Americas, 0.07 per 1000 in Europe, 0.68 per 1000 in South and Southeast Asia and 10.68 per 1000 in Africa [7]
Summary
Hemoglobinopathies are a group of hereditary diseases first described in 1910 by Herrick when investigating black patients with the disease who had anemia, abdominal pain and joint pain [1]. The most prevalent in our population are hemoglobins S and C, which are capable of producing disease when homozygous. Sickle cell anemia affects about 100,000 individuals in the United States, and approximately two million Americans carry the sickle cell trait [3]. Inheriting the Sickle Cell Anemia gene from both parents results in homozygous (SS) sickle cell disease which is usually severe [5]. In cases of double heterozygotes with sickle hemoglobin C (SC), the disease is less expressive in its clinical condition [5] and rarer. Due to the rarity of the nosological entity and its importance to the academic community, it was aimed to discuss a case of patient affected by SC Hemoglobinopathy, who presented osteomyelitis and septic arthritis
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