Vaso-occlusive crises are the most common manifestation of sickle cell disease (SCD) and the main cause of hospital admission in these patients. There is emerging evidence that vaso-occlusive pain has both nociceptive and neuropathic components. However, the treatment of SCD-related pain with neuropathic drugs has not yet been systematically studied, particularly in children. We describe a 14-year-old girl with SCD and multiple hospital admissions for pain management for severe acute vaso-occlusive pain episodes. The patient was evaluated by a multidisciplinary team of specialists which considered that the chronic, refractory pain she was experiencing for years was probably neuropathic in origin and it was decided to start oral gabapentin (300 mg/day). At 10 months follow-up, the patient reported remarkable improvement in her quality of life with a significant decrease in the number of hospital admissions (three admissions for acute vaso-occlusive pain episodes in 10 months versus the previously monthly recurrences).

Results: Out of 216 stool cultures, 98 (45%) were positive. We identified Campylobacter in 49 (50%) cases; 30 (61%) were female. Median age was 23 months. Fourteen patients were under one year of age, 25 between one and five years old and 10 patients were over five years old. Watery diarrhea was identified in 5 (10%) patients, bloody diarrhea in 44 (90%) and mucosanguineous in 14 (29%), while 23 (47%) had fever, 14 (29%) complained of abdominal pain and 11 (22%) presented with vomiting. One patient was septic. Five patients were admitted as inpatients. Eight patients were treated with azithromycin. Discussion: This is the largest published national series on gastroenteritis by Campylobacter in children and the first in the south region. Campylobacter was the main bacteria isolated. Infection was self-resolving in the majority of cases. Nevertheless, severe forms of this infection should be considered. Increased resistance to quinolones is worrisome. Conclusion: Judicious use of stool cultures allows etiological identification of bacterial gastroenteritis. The increase in Campylobacter cases reinforces the need for better control of hygiene measures in handling food products.

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