Question

A boy presented with multiple non-suppurative osteomyelitis along with sickle cell anaemia. What will be the causative organism?

• A. Salmonella
• B. S. aureus
• C. H. influenzae
• D. Enterobacter species

Hint:

Sickle cell plus osteomyelitis is a classic pairing pointing to an enteric organism, not staph.

Answer 1

The Correct Option is A

Step 1: In the general population, Staphylococcus aureus is the most common cause of osteomyelitis across nearly all age groups.
Step 2: However, the clinical context here is sickle cell anaemia. In patients with sickle cell disease, Salmonella species are the most common and characteristic cause of osteomyelitis, classically multifocal.
Step 3: The reason is that bowel microinfarction from sickling allows Salmonella to enter the bloodstream, while functional asplenia and impaired opsonisation reduce clearance of these organisms, predisposing to Salmonella bone and joint infection.
Step 4: Hence, although S. aureus, H. influenzae and Enterobacter cause osteomyelitis generally, the sickle cell association makes Salmonella the correct answer.