In patients with sickle cell disease, Salmonella species are the most frequent cause of osteomyelitis due to their ability to invade the damaged bone tissue. Sickle cell-related bone infarctions create a nidus for infection, and Salmonella, a facultative intracellular pathogen, thrives in this environment. While Staphylococcus aureus is the most common cause of osteomyelitis in the general population, in sickle cell patients, the risk for Salmonella is significantly higher. This reflects the specific vulnerability caused by spleen dysfunction and ischemic bone damage in these patients.

Reference:
Harrison’s Principles of Internal Medicine, 20th Edition, Volume 2, Chapter 228 (Sickle Cell Disease)