WIP 132 - A Descriptive Analysis of the Clinical Presentation, Diagnosis, and Diagnostic Challenges in Patients with Osteomyelitis with Sickle Cell Disease at Children’s National Hospital
Pediatric Resident (PL-3) Children's National Health System Rockville, Maryland, United States
Background: Osteomyelitis (OM) is a significant cause of morbidity in patients with sickle cell disease (SCD). However, diagnosing osteomyelitis in SCD patients is challenging. First, vaso-occlusive crisis (VOC) produces similar clinical, radiographic, and lab findings, making the two diagnoses difficult to differentiate without culture data. Second, patients with SCD are often started on empiric antibiotics upon febrile presentation to the hospital, potentially lowering the yield of bone culture. Microbiological and clinical outcomes data of OM in children with SCD over recent years at our institution may help address these diagnostic challenges by informing evidence-based empiric treatment for this population, particularly in cases where bone sampling is not attainable. Objective: The aim of this single-center study is to describe the epidemiology, microbiology, and clinical outcomes of osteomyelitis (OM) in children with sickle cell disease (SCD) over a 6-year period (2017-22). Design/Methods: Patients are identified through the electronic medical record using ICD-10 codes related to OM and SCD. We will include patients with SCD, 0 to 21 years of age, with diagnoses of suspected OM from 2017-2022. We will exclude patients with chronic OM, sickle cell trait or retained orthopedic hardware. Once patients are identified, retrospective chart review is performed. Clinical data including presenting signs and symptoms (pain, presence of fever, point tenderness), imaging results, basic laboratory findings (ESR, CRP, WBC count, etc), all microbiologic data (blood and bone culture results including antibiotic susceptibilities, as well as any molecular study results), and antibiotic treatment will be collected and entered into a REDCap database. Once data is fully obtained (by 1/31/24), qualitative data will be displayed via pie chart, scatter plot, or descriptive text (by 2/28/24). Interpretation and poster will be done by 3/31/24.
