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Case Report
Treating chronic osteomyelitis in a sickle cell child using multimodal approach: A novel case in a 14-year-old boy
1 MBBS, BSc, Resident Orthopedics, Salmaniya Medical Complex, Bahrain
2 MUDr, ARAB (Ortho), Head of the Department Orthopaedics, Peadatric Orthopaedic Consultant, Salmaniya Medical Complex, Bahrain
3 MBBS, MS (Orthopedics), Chief Resident Orthopedics, Salmaniya Medical Complex, Bahrain
Address correspondence to:
Sadaf Mohammed Basheer
MBBS, BSc, Resident Orthopedics, Salmaniya Medical Complex,
Bahrain
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Article ID: 101052Z01SB2019
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Basheer SM, Karashi AR, Basith MA. Treating chronic osteomyelitis in a sickle cell child using multimodal approach: A novel case in a 14-year-old boy. Int J Case Rep Images 2019;10:101052Z01SB2019.ABSTRACT
Introduction: Sickle cell hemoglobinopathy is a frequent cause of morbidity mostly in terms of vaso-occlusive crises and osteomyelitis, treatment of which is demanding as there is no set protocol to date designed for this subset of patients.
Case Report: We report a case of a 14-year-old sickle cell boy who presented to us with chronic osteomyelitis involving the distal aspect of right radius and in whom the infection was successfully eradicated using multimodal treatment regimen which included a course of intravenous (IV) antibiotics along with surgical debridement and implantation of local antibiotic delivery system followed by appropriate course of oral antibiotics.
Conclusion: Complete eradication of chronic osteomyelitis infection in a sickle cell patient represents challenge due to the pathophysiology of the disease which is significantly different in the patients. To our knowledge, this is the first reported case of such a combination therapy in pediatric sickle cell population in particular the usage of local antibiotic therapy in the form of cement beads which resulted in successful resolution of the osteomyelitis infection. Though this case alone does not provide sufficient proof but it does validate the concept of usage of multimodal therapy for treatment of similar infections in sickle cell population for further analytical studies.
Keywords: Chronic osteomyelitis, Multimodal therapy, Pediatrics, Sickle cell
SUPPORTING INFORMATION
Author Contributions
Sadaf Mohammed Basheer - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Ali Redha Karashi - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mohammed Abdul Basith - Substantial contributions to conception and design, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Sadaf Mohammed Basheer et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
