Shigella sonnei Osteomyelitis and Sickle-Cell Anemia

THE association ofSalmonellaosteomyelitis and sickle-cell disease has been well documented.1-4It is frequently difficult to distinguish the symptoms of osteomyelitis from the hand-foot syndrome seen in sickle-cell anemia, especially during the early stages of the osteomyelitic process. It is the purpose of this paper to report a case of osteomyelitis caused byShigella sonnei, where the patient presented with the hand-foot syndrome. Report of a Case A 23-month-old Negro girl was considered well until 11 months of age, when she developed pain and swelling of the dorsal surfaces of both hands and feet in conjunction with a respiratory infection. A sodium bisulfite preparation showed sickling of the red blood cells, and electrophoresis revealed the presence of homozygous hemoglobin S. During the following 12 months, the patient had four similar episodes. At 23 months of age, the patient was brought to the emergency room with a one-hour history