Gangrene and sepsis in sickle cell disease

Abstract

Infection is common in sickle cell disease (SCD), and consequences of infection such as abscess formation and osteomyelitis are commonly reported events. However, gangrene is an uncommon complication of SCD. A 3-year-old boy with sickle cell anemia presented with fever, bone pains, and gangrene of the digits. Peripheral pulses were palpable. His full blood count showed a progressive increase of the white blood cell count, but the clotting profile was normal, and blood culture yielded Proteus vulgaris. Arterial Doppler scan showed reduced flow in the right ulnar and both dorsalis pedis arteries. X-ray of the upper and lower limbs showed chronic osteomyelitis. Pus aspirate from incision and drainage of anterior tibia abscesses showed Gram-negative cocci in clusters, but the culture was negative. He received blood transfusion, fresh frozen plasma, heparin, and antibiotics. Early recognition and prompt treatment of infection will minimize the development of these devastating complications of SCD.

Keywords

• chronic osteomyelitis
• digital gangrene
• multifocal abscess
• sickle cell anemia