Chronic melioidosis presenting with multiple abscesses

Goel, Anshul; Bansal, Rahul; Sharma, Shweta; Singhal, Suman; Kumar, Ashok

doi:10.1093/omcr/omw034

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…Patients with risk factors can deteriorate rapidly with the formation of disseminated abscesses, pneumonia, septicemia, and shock. [81][82][83] The causal bacterium has been detected in sputum, urine, tissue samples, or…”

Section: Other Emerging or Rare Travel-related Diseasesmentioning

confidence: 99%

“…Patients with risk factors can deteriorate rapidly with the formation of disseminated abscesses, pneumonia, septicemia, and shock. [ 81 , 82 , 83 ] The causal bacterium has been detected in sputum, urine, tissue samples, or blood, but culture requires specific biosafety measures. Repetitive cultures should be taken because negative results are frequently observed in septic patients.…”

Section: Other Emerging or Rare Travel-related Diseasesmentioning

confidence: 99%

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The emergence of travel-related infections in critical care units

Herten¹,

Vlieghe

Bottieau

et al. 2022

Journal of Translational Internal Medicine

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Several tropical or geographically confined infectious diseases may lead to organ failure requiring management in an intensive care unit (ICU), both in endemic low- and middle-income countries where ICU facilities are increasingly being developed and in (nonendemic) high-income countries through an increase in international travel and migration. The ICU physician must know which of these diseases may be encountered and how to recognize, differentiate, and treat them. The four historically most prevalent “tropical” diseases (malaria, enteric fever, dengue, and rickettsiosis) can present with single or multiple organ failure in a very similar manner, which makes differentiation based solely on clinical signs very difficult. Specific but frequently subtle symptoms should be considered and related to the travel history of the patient, the geographic distribution of these diseases, and the incubation period. In the future, ICU physicians may also be more frequently confronted with rare but frequently lethal diseases, such as Ebola and other viral hemorrhagic fevers, leptospirosis, and yellow fever. No one could have foreseen the worldwide 2019–up to now coronavirus disease 2019 (COVID-19) crisis caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was initially spread by travel too. In addition, the actual pandemic due to SARS-CoV-2 reminds us of the actual and potential threat of (re)-emerging pathogens. If left untreated or when treated with a delay, many travel-related diseases remain an important cause of morbidity and even mortality, even when high-quality critical care is provided. Awareness and a high index of suspicion of these diseases is a key skill for the ICU physicians of today and tomorrow to develop.

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Section: Other Emerging or Rare Travel-related Diseasesmentioning

confidence: 99%

Section: Other Emerging or Rare Travel-related Diseasesmentioning

confidence: 99%

The emergence of travel-related infections in critical care units

Herten¹,

Vlieghe

Bottieau

et al. 2022

Journal of Translational Internal Medicine

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“…pseudomallei causes melioidosis and is endemic in most parts of southeast Asia with a fatality rate of up to 30% [14]. It generally presents with fever, abscess, acute pneumonia and septicemia and is called a great imitator of tuberculosis [15]. Rapid detection of B. pseudomallei would help initiate early antimicrobial therapy that could significantly improve patient outcome.…”

Section: Subject Recruitment and Sample Collectionmentioning

confidence: 99%

A novel multiplex real-time PCR for the detection of Salmonella Typhi, Salmonella Paratyphi A and Burkholderia pseudomallei in clinical samples

Saravanan¹,

Rajendiran²,

Sankar³

et al. 2019

APJHS

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Enteric fever, caused by infection with Salmonella Typhi or Paratyphi A, B, or C (typhoidal Salmonella) and melioidosis are among the most common bacterial causes of acute febrile illness in tropical and subtropical countries. The diseases are widely spread even in developed countries mainly affecting travellers returning from endemic areas. Melioidosis is an increasingly recognized fatal septicemic infection also mimicking tuberculosis. These pathogens are largely underreported due to lack of sensitive and specific diagnostic tools. In this study, an inhouse multiplex real-time PCR assay was developed for the simultaneous detection of Salmonella Typhi, S. Paratyphi A and B. pseudomallei using specific primers. The inhouse developed assay was evaluated on buffy coat and serum samples collected from patients with acute febrile illness at four different centres. The assay had a detection limit of less than 1 genome copy for S. Typhi and S. Paratyphi A and 18 genome copies per 10 µl of PCR input for B. pseudomallei. Among the 1101 samples tested by multiplex real-time PCR, one (0.09%) sample was positive for S. Typhi. One sample was positive for blood culture identified as S. Typhi but negative by real-time PCR. The samples were negative for S. Paratyphi A and B. pseudomallei. The multiplex real-time assay would be highly useful as a diagnostic aid for the syndromic approach and comprehensive diagnosis of enteric fever and melioidosis. The assay could improve the overall diagnostic capability and be a useful tool during outbreak investigations.

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“…Those cases were characterized by travel history or history of exposure to imported animals, soil or even plant [4]. The clinical spectrum of melioidosis is broad, which ranges from subclinical cases to fulminant septicemia with disseminated abscesses especially in immunocompromised patients [5].…”

Section: Introductionmentioning

confidence: 99%

Melioidosis: misdiagnosed in Nepal

et al. 2019

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Background Melioidosis is a life-threatening infectious disease that is caused by gram negative bacteria Burkholderia pseudomallei . This bacteria occurs as an environmental saprophyte typically in endemic regions of south-east Asia and northern Australia. Therefore, patients with melioidosis are at high risk of being misdiagnosed and/or under-diagnosed in South Asia. Case presentation Here, we report two cases of melioidosis from Nepal. Both of them were diabetic male who presented themselves with fever, multiple abscesses and developed sepsis. They were treated with multiple antimicrobial agents including antitubercular drugs before being correctly diagnosed as melioidosis. Consistent with this, both patients were farmer by occupation and also reported travelling to Malaysia in the past. The diagnosis was made consequent to the isolation of B. pseudomallei from pus samples. Accordingly, they were managed with intravenous meropenem followed by oral doxycycline and cotrimoxazole. Conclusion The case reports raise serious concern over the existing unawareness of melioidosis in Nepal. Both of the cases were left undiagnosed for a long time. Therefore, clinicians need to keep a high index of suspicion while encountering similar cases. Especially diabetic-farmers who present with fever and sepsis and do not respond to antibiotics easily may turn out to be yet another case of melioidosis. Ascertaining the travel history and occupational history is of utmost significance. In addition, the microbiologist should be trained to correctly identify B. pseudomallei as it is often confused for other Burkholderia species . The organism responds only to specific antibiotics; therefore, correct and timely diagnosis becomes crucial for better outcomes.

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Chronic melioidosis presenting with multiple abscesses

Cited by 7 publications

References 15 publications

The emergence of travel-related infections in critical care units

The emergence of travel-related infections in critical care units

A novel multiplex real-time PCR for the detection of Salmonella Typhi, Salmonella Paratyphi A and Burkholderia pseudomallei in clinical samples

Melioidosis: misdiagnosed in Nepal

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