Question

In enteric fever, bone and joint infection is seen especially in children having

• A. Aplastic anaemia
• B. HIV disease
• C. Sickle cell disease
• D. HbsAg +ve hepatitis

Hint:

Think about which blood disorder causes bone infarcts that let Salmonella take hold.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
The question asks which underlying condition predisposes children with enteric fever to bone and joint infection.

Step 2: Key Concept or Approach:
Salmonella species, the organism responsible for enteric fever, has a well-known predilection for causing osteomyelitis in patients with sickle cell disease. Chronic hemolysis, microinfarction of bone from sickled cells, and functional hyposplenism in sickle cell disease impair the ability to clear Salmonella from the bloodstream and from areas of bone with poor blood supply, allowing the organism to seed and infect bone and joints.

Step 3: Working Through the Options:
Aplastic anaemia causes marrow failure and general susceptibility to infection but is not the classic association with Salmonella bone infection. HIV disease increases susceptibility to non-typhoidal Salmonella bacteremia, but the textbook link with Salmonella osteomyelitis is sickle cell disease, not HIV. Sickle cell disease is the classic predisposing condition for Salmonella osteomyelitis because of bone infarction and functional asplenia, making affected children especially prone to bone and joint infection during enteric fever. HbsAg positive hepatitis reflects chronic hepatitis B infection and has no established link to Salmonella bone infection.

Step 4: Conclusion:
The correct answer is sickle cell disease, the classic risk factor for Salmonella osteomyelitis.