Bone infection: osteomyelitis: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone infection: osteomyelitis

Sample item

An 8-year-old with sickle cell disease has fever and pain over the tibia with MRI features of osteomyelitis. Which organism is more common in these patients than in the general population?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Salmonella species

Staphylococcus aureus remains the commonest cause of osteomyelitis overall, but patients with sickle cell disease are particularly prone to Salmonella osteomyelitis, from infarcted bowel and bone that provide a nidus, and from functional asplenia. Bone infarction can be difficult to distinguish clinically from infection.

Option by option

  • A. Mycobacterium leprae

    Leprosy bacilli rarely cause osteomyelitis in this setting.

  • B. Salmonella species (correct)

    Correct. Salmonella is characteristically over-represented in sickle cell osteomyelitis.

  • C. Candida albicans

    Candida causes osteomyelitis mainly in immunosuppressed or intravenous drug users.

  • D. Pseudomonas aeruginosa

    Pseudomonas is associated with puncture wounds through shoes and with injection drug use.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Salmonella species. Staphylococcus aureus remains the commonest cause of osteomyelitis overall, but patients with sickle cell disease are particularly prone to Salmonella osteomyelitis, from infarcted bowel and bone that provide a nidus, and from functional asplenia.

Why is "Mycobacterium leprae" not the answer?

Leprosy bacilli rarely cause osteomyelitis in this setting.

Why is "Candida albicans" not the answer?

Candida causes osteomyelitis mainly in immunosuppressed or intravenous drug users.

Why is "Pseudomonas aeruginosa" not the answer?

Pseudomonas is associated with puncture wounds through shoes and with injection drug use.

What concept does this question test?

It tests Bone infection: osteomyelitis in Orthopaedics. Bone infarction can be difficult to distinguish clinically from infection.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone infection: osteomyelitis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.