Case Review of Melioidosis in a Tertiary Care Centre from Northern Sri Lanka (original) (raw)
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Melioidosis in Sri Lanka: an emerging infection
Sri Lankan Journal of Infectious Diseases, 2012
Melioidosis, a pyogenic infection that presents acutely or as a chronic infection, is caused by the soil-associated bacterium Burkholderia pseudomallei. Infection is acquired by inoculation or inhalation and is more common in patients with underlying chronic disease. It is endemic in the tropical belt. Although Sri Lanka is not considered as a country where melioidosis is endemic, an increasing number of cases have been reported recently. Definitive diagnosis requires the isolation of B. pseudomallei in culture from clinical specimens. However, the laboratory diagnosis of melioidosis in Sri Lanka and other under-resourced countries is limited by a lack of familiarity with the bacterium and a lack of facilities to accurately confirm the identity of the isolate. It is highly likely that melioidosis is under-diagnosed in this country. There is a need to increase awareness of this infection among clinicians and clinical microbiologists and improve laboratory facilities for the selective isolation and accurate identification of B. pseudomallei. In addition, studies are needed to determine the epidemiology of melioidosis in Sri Lanka.
Journal of Rangpur Medical College
Bangladesh is an example of a highly populous, agricultural country where melioidosis may be a significantly underdiagnosed cause of infection and death. Melioidosis is caused by a highly pathogenic, soil-borne, Gram-negative bacterium, Burkholderia pseudomallei. Diabetes mellitus is the most common risk factor. Disease manifestations vary from pneumonia or localized abscess to acute septicemia or arthritis. Culture is considered the current gold- standard for diagnosis. For the intensive phase (10 to 14 days), ceftazidime or meropenem is the drug of choice. For the eradication phase (3 to 6 months), oral trimethoprim/ sulfamethoxazole is the drug of choice. Surgery (drainage of abscess) has an important role in the management of melioidosis. A 48-year-old male, health worker of an NGO, working at Cox’s Bazar presented with fever for 1 month and gradual increasing pain and swelling of the left knee for 7 days followed by cellulitis and multiple abscess formation in the left leg. B. ...
Journal of Medical Case Reports, 2020
Background Melioidosis is a potentially fatal bacterial infection caused by Burkholderia pseudomallei. The existence of melioidosis in Sri Lanka was once unheard of, and entertaining it as a diagnosis in clinical practice was extremely rare. Case presentation In this case report, we describe the clinical, epidemiological, and longitudinal follow-up data of a 58-year-old previously healthy Sinhalese woman who presented to our hospital with protracted febrile illness of 5 weeks’ duration, later developing multiple abscesses at different sites of the body. There was a significant delay in confirming the diagnosis of melioidosis by isolating B. pseudomallei from blood and pus cultures. The patient recovered fully with a prolonged course of antibiotics and has remained in good health over the last 13 years without recurrence. Despite being immunocompetent, she had contracted the infection by a brief contact with mud soil in a footpath. Conclusions A high index of clinical suspicion along...
Sri Lankan Journal of Infectious Diseases, 2012
Melioidosis is an emerging infection in Sri Lanka. Since the clinical presentation of melioidosis is not distinctive, a high index of clinical suspicion is required. Definitive diagnosis is usually made by isolation of the causative bacterium, Burkholderia pseudomallei, in culture. Although it is not a difficult bacterium to culture, initial identification of the isolate requires prior experience with B. pseudomallei. A case report of a patient with acute onset of lung abscess with a positive sputum culture for B. pseudomallei is presented.
Melioidosis: An emerging infection in India
IP Innovative Publication Pvt. Ltd, 2017
Introduction: Melioidosis is caused by Burkholderia pseudomallei which is endemic in South East Asia. Lack of proper microbiological services in many countries results in under-reporting of cases and the global burden of infection remains underestimated. This is a study to analyse the clinical presentation and risk factors for melioidosis in India. Materials and Method: A retrospective study was carried out on ten culture proven cases of melioidosis in a tertiary care hospital in South India between January 2009 and December 2014. Result: Ten cases were studied in five years of which nine were males. They had varying clinical presentations like loss of weight and loss of appetite(10%), fever(60%), headache(10%), abdominal pain(20%), joint pain(10%), weakness of limbs(10%), swelling of thigh(20%) and faecal and urinary incontinence((10%). The risk factors included diabetes mellitus (100%), alcohol consumption(90%)and tuberculosis(30%). All the isolates were sensitive to Ceftazidime, Piperacillin-tazobactam, Imipenem, Cotrimoxazole, Amoxycillin-clavulanate and Meropenem while only 80% were sensitive to Ciprofloxacin. Of the 10 cases, two expired and the rest responded to treatment. Conclusion: Melioidosis is an emerging infection in India especially in males and diabetes and alcoholism are identified as the commonest risk factors. Control of the disease requires close monitoring, improved clinical laboratory standards and aggressive therapy.
Melioidosis: An under-diagnosed entity in western coastal India: A clinico-microbiological analysis
Indian Journal of Medical Microbiology, 2007
Clinico-microbiological analysis of a series of 25 patients with culture proven melioidosis was done. All patients came from the coastal regions of Kerala and Karnataka and presented between June 2005 to July 2006. They were analysed with respect to clinical presentation, occupation, epidemiology and microbiological features. No single presenting clinical feature was found to be typical of melioidosis. The disease was found to mimic a variety of conditions, including tuberculosis and malignancy. Burkholderia pseudomallei was isolated from blood, sputum, pus, urine, synovial, peritoneal and pericardial ß uids. Diabetes mellitus was the most common predisposing factor and 80% of the cases presented during the Southwest monsoon (June to September). It is probable that melioidosis is highly prevalent in western coastal India and yet, greatly underestimated. Better awareness, both among clinicians and microbiologists, coupled with improved diagnostic methods to allow early diagnosis and hence early treatment, will signiÞ cantly reduce the morbidity and mortality associated with this disease.
MELIOIDOSIS - A CASE SERIES FROM DAKSHIN KANNADA.
Melidiosis is an infectious disease caused by gram negative organism Burkholderia pseudomallei. B.pseudomallei often described as soil dwelling organism resembling safety pin appearence on microbiological appearance. Melidi-osis is endemic in South east Asia and Australia. Risk Factors have been associated are Diabetes, alcohol abuse, chronic kidney disease and chronic lung disease.In this case series of melidiosis from 2015-16 encountered in tertiary hospital.We emphasise on treatment modality at our hospital KS HEGDE hospital using meropenem as a first line antibiotics with ceftazidime.
Melioidosis in Southern India: Epidemiological and clinical profile
The Southeast Asian journal of tropical medicine and public health
Melioidosis, which is mainly prevalent in Thailand and Australia, has shown an increasing trend in India in the last few years. We carried out a retrospective study of 25 culture-proven adult cases of melioidosis who were admitted to a tertiary care hospital in southern India during June 2001 to September 2007. There was a six-fold increase in the number of cases in 2006 and 2007 as compared to 2001. Diabetes mellitus was the predisposing factor in 68% of cases, followed by alcoholism (28%). The clinical presentations were fever (80%), pneumonia and/ or pleural effusion (48%), hepatomegaly (56%), joint involvement, and/or osteomyelitis (48%), splenomegaly (40%), splenic abscess (24%) and septicemia (28%). The organism, Burkholderia pseudomallei, was sensitive to co-amoxiclav, cotrimoxazole, ceftazidime, and carbapenem. The study suggests that melioidosis is an emerging infectious disease in the southwestern coastal belt of India, and it is likely to happen at much higher incidence.
Melioidosis- Report of Two Cases
Journal of Clinical & Biomedical Research, 2020
Melioidosis which is caused by burkholderia pseudomallei occurs predominantly in Southeast Asia. Cases are now being reported from india as well. It can present with varying clinical manifestations like pneumonia, septicemia, arthritis, abscess etc. Neurologic meliodiosis, though rare can occur in upto 3-4% cases. Here we present two cases of melioidosis from Indian subcontinent, one involving central nervous system causing cerebral abscess and second one involving multiple splenic and liver abscess with bacteremia. First patient with cerebral abscess was managed with surgical debridement with antibiotics and discharged in a stable condition after 15 days while the bacteremic patient developed septic shock with mutiorgan failure and succumbed to death after 12 days of treatment