Article

4 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates

  • You can purchase this item in Pay Per ViewPay per View - FAQ : 30,00 € Taxes included to order
    Pages Iconography Videos Other
    5 4 0 0


Archives de pédiatrie
Volume 20, n° 4
pages 398-402 (avril 2013)
Doi : 10.1016/j.arcped.2013.01.019
Received : 14 October 2012 ;  accepted : 23 January 2013
Infection ostéoarticulaire multifocale à Salmonella non typhi chez une enfant drépanocytaire
Multifocal osteoarticular infection caused by Salmonella non typhi in a child with sickle cell disease
 

B. Cabaret a, , M.-L. Couëc b, M. Lorrot c, E. Launay d, C. Gras-Le Guen e
a Urgences pédiatriques, CHU de Nantes, 9, rue Quai-Montcousu, 44000 Nantes, France 
b Oncologie pédiatrique, CHU de Nantes, 9, rue Quai-Montcousu, 44000 Nantes, France 
c Service de pédiatrie générale, CHU Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France 
d Pédiatrie nourrisson, CHU de Nantes, 9, rue Quai-Montcousu, 44000 Nantes, France 
e Réanimation pédiatrique, CHU de Nantes, 9, rue Quai-Montcousu, 44000 Nantes, France 

Auteur correspondant.
Résumé
Introduction

La drépanocytose est l’hémoglobinopathie héréditaire monogénique la plus fréquente. L’évolution de la maladie est marquée par la survenue de crises vaso-occlusives (CVO), d’épisodes aigus d’anémie hémolytique sur un fond d’anémie hémolytique chronique, et d’infections potentiellement sévères.

Observation

Une enfant de 2ans, atteinte d’une drépanocytose SS, avait présenté un sepsis grave à Salmonella non typhi . Le sepsis avait été difficilement contrôlé évoluant vers une infection ostéoarticulaire multifocale malgré une antibiothérapie intraveineuse prolongée. La prise en charge avait été longue et compliquée de plusieurs infections nosocomiales et d’un arrêt cardio-respiratoire responsable de séquelles neurologiques sévères.

Conclusion

L’infection ostéoarticulaire à Salmonella non typhi est une complication fréquente des sepsis à salmonelles chez les patients drépanocytaires et sa prise en charge reste difficile. Ce cas clinique illustre la gravité extrême des infections osseuses chez ces patients et met en avant la nécessité d’une prise en charge urgente et intensive de ces infections tant par l’antibiothérapie que par le traitement transfusionnel.

The full text of this article is available in PDF format.
Summary
Introduction

Sickle cell disease is the most common monogenic hereditary hemoglobinopathy. Its course is marked by vaso-occlusive crises (VOC), episodes of acute hemolytic anemia on a background of chronic hemolytic anemia, and severe infections.

Case report

A 2-year-old child with sickle cell disease presented with severe sepsis caused by Salmonella non typhi . Control of the sepsis was difficult, with multifocal osteomyelitis and arthritis, which required prolonged intravenous antibiotic therapy. Prolonged treatment was complicated by cardiorespiratory arrest and severe neurological damage, as well as nosocomial infections.

Conclusion

Osseous articular infections caused by Salmonella non typhi are a common complication in children with sickle cell disease, which need to be promptly recognized. Management remains a great concern. The clinical case reported herein is original in its multifocal evolution. It illustrates the vulnerability of patients with sickle cell disease and the need for urgent and intensive care in the case of infection.

The full text of this article is available in PDF format.


© 2013  Elsevier Masson SAS. All Rights Reserved.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline