In Aug. '95 a 10 month old boy with SS disease presented to the St. Luke's-Roosevelt Hospital Center's Emergency Department with tender swelling of both hands, and an elevated temperature. Over the succeeding 2 days, the swelling of the left hand increased, markedly, and was accompanied by redness, warmth, and exquisite tenderness, as well as fluctuation. The area was aspirated, yielding several cc of pus, grew Salmonella type B. Bone scan subsequently revealed osteomyelitis of 2 meta carpal bones. Symptoms and signs regressed completely within one week. The child was treated with a total of 6 weeks of I.V. antibiotics.

Retrospective chart review from two of the Columbia University Comprehensive Sickle Cell Center Hospitals unearthed 4 additional cases, of patients aged 8 months to 2½ years with similar diagnosis of osteomyelitis initially presenting with a subcutaneous loculation of pus, and one case which presented with pus, positive for Salmonella, obtained from the right elbow joint where it had extravasated from the distal end of the humerus.

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