Melioidosis mimicking pulmonary tuberculosis

Pathirathne, S.; Athukorala, GP; Hussain, Hamidah; Nishantha, P.L.B.; Senevirathne, H.M.P.K.; Corea, Enoka; Siribaddana, Anoma

doi:10.4038/sljm.v24i1.5

Cited by 1 publication

(1 citation statement)

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“…As a result of a World Health Organization-supported laboratory-twinning project, additional cases were confirmed in the Central and Western Provinces in 2006 and 2008 [ 17 , 18 ] and surveillance for melioidosis was commenced. Recently, further cases from Sri Lanka, diagnosed locally and overseas, have been published [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Section: Introduction and History Of Melioidosis In The Countrymentioning

confidence: 99%

Melioidosis in Sri Lanka

2018

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Until recently, Sri Lanka was not considered a country with endemic melioidosis. However, an increasing number of cases is being reported. National surveillance for melioidosis was instituted after 2008. A total of 250 culture-positive cases was recorded between 2006 and May 2017. Males predominated (71.6%). The age range was wide (2–92 years) reflecting a ubiquity of exposure. The majority (201/250, 80%) lived in rural areas. All provinces were affected. Case load increased during the two monsoonal periods (67%). There was representation of every population group including farmers (n = 44), housewives (n = 24), school children (n = 10), professionals (n = 5), businesspersons (n = 6), white-collar workers (n = 10) and blue-collar workers (n = 8). Diabetes was the predominant risk factor (n = 163, 65.2%). Clinical presentations included community-acquired sepsis and pneumonia, superficial and deep abscesses, and septic arthritis. Mortality was 20.4% (51/250). A majority (n = 212) of isolates belonged to the YLF (Yersinia-like fimbrial) clade but 38 were BTFC (B. thailandensis-like flagellum and chemotaxis). A total of 108 isolates was genotyped and 46 sequence types (STs) were identified, 40 being novel. It is clear that melioidosis is endemic in Sri Lanka with a wide geographic and demographic distribution. There is an urgent need to extend surveillance of melioidosis to under-resourced parts of the country and to populations at high risk.

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