Salmonella Osteomyelitis SCD — SCE Infectious Diseases MCQ

Correct answer: B — Sickle-mediated bone infarction creates a microenvironment conducive to Salmonella infection — devitalised bone with impaired local immunity provides a niche for bacterial colonisation

In sickle cell disease, recurrent vaso-occlusive crises cause bone marrow and cortical bone infarction. The infarcted bone provides an ideal environment for Salmonella colonisation: devitalised tissue with impaired local blood supply, reduced oxygen tension, and compromised local immune function. Additionally, sickle cell patients have functional asplenia (reducing clearance of encapsulated organisms) and impaired opsonisation. Salmonella is the most common cause of osteomyelitis in SCD — more common than S. aureus (which predominates in the general population).

Reference: BSH 2022 – Sickle cell disease; NICE 2024 – SCD complications