MRCP2-4668

MRCP2-4668

A 7 year-old boy from Sierra Leone presents with a 1 week history of painful left leg. He is homozygous for sickle cell disease. On examination the child is febrile at 40.2ºC and there is bony tenderness over the left tibial shaft. Investigations are:

Hb 7.1 g/dL
Blood culture Gram negative rods

X-ray left tibia: Osteomyelitis – destruction of bony cortex with periosteal reaction.

Which pathogen is most likely responsible for the osteomyelitis in this case?