Characteristics, clinical outcomes and factors influencing mortality of patients with melioidosis in southern Thailand: A 10-year retrospective study

Churuangsuk, Chaitong; Chusri, Sarunyou; Hortiwakul, Thanaporn; Charernmak, Boonsri; Silpapojakul, Khachornsakdi

doi:10.1016/j.apjtm.2016.01.034

Cited by 38 publications

(62 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study found that hepatic or splenic abscess and/or skin and soft tissue infection were the most common clinical profiles and the most important clinical predictors of pediatric melioidosis. A previous study on melioidosis in our hospital from 2002 to 2011 which recruited all patients aged more than 1 year found that the median (IQR) age of infection was 49 (34-58) years and the proportion of patients with hepatic abscess was 19.4% and with splenic abscess was 20.9% [3]. In the current study which enrolled only children in contrast to the all-ages study, we found similar proportions of children with hepatic abscess 29.6% (8/27) and splenic abscess 22.2% (6/27).…”

Section: Discussionmentioning

confidence: 94%

“…It is an important public health problem in areas in which it is endemic such as Southeast Asia and northern Australia [1,2]. Clinical presentation ranges from a localized infection, such as parotitis or skin abscess, to severe septicemia [3][4][5]. In a study from northeastern Thailand, Limmathurotsakul et al reported an estimated melioidosis mortality rate of 8.6 per 100,000 population (95% confidence interval (95% CI): 7.33-10.11), the third most common cause of death from infectious disease in northeastern Thailand, following human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatic/splenic abscess and/or skin and soft tissue infection as predictors of melioidosis in children

Chanvitan

Geater

Laoprasopwattana

2019

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Melioidosis can have multiple organ involvement which can then mimic other infections. The aim of this study was to determine if there are any factors significantly associated with melioidosis which can inform diagnostic evaluations before receiving the results of confirming laboratory testing. Methodology: The charts of patients aged < 16 years admitted to Songklanagarind Hospital during 2002-2014 with a clinical presentation suspicious of melioidosis were reviewed. Results: Of the 145 suspected cases, 27 patients had a confirmed diagnosis of melioidosis by either serology and/or culture. The melioidosis group had a higher proportion of patients with liver or splenic abscess (44.4% vs. 11.9%, p < 0.01) and were less likely to have splenomegaly by physical examination (3.7% vs. 22.9%, p = 0.02) than patients without melioidosis. Logistic regression analysis found that patients suspected of melioidosis who had (a) hepatic abscess or (b) splenic abscess or (c) skin or soft tissue infection were more likely to have melioidosis with likelihood ratios of 5.6, 4.0, and 2.2 respectively, and specificities of 0.94, 0.89, and 0.68 respectively. Suspected patients who did not have hepatic abscess, splenic abscess, or soft tissue infection were unlikely to have melioidosis with negative predictive value of 0.90. Conclusion: patients who have clinically suspected melioidosis without skin or soft tissue infection should have hepatic-splenic ultrasonography performed, and suspected patients who have one of these 3 findings should be treated initially as melioidosis while waiting for culture or serologic test results.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Hepatic/splenic abscess and/or skin and soft tissue infection as predictors of melioidosis in children

Chanvitan

Geater

Laoprasopwattana

2019

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…A male‐biased incidence was found among the neonatal melioidosis cases (68%; 15/22), similar to childhood and adult melioidosis . The odds of fatal outcome were found 3.67 times higher among male than the odds were among female neonates.…”

Section: Discussionmentioning

confidence: 99%

“…A male-biased incidence was found among the neonatal melioidosis cases (68%; 15/22), similar to childhood 3,4,19 and adult melioidosis. 14,[20][21][22] The odds of fatal outcome were found 3.67 times higher among male than the odds were among female neonates. Association of the male sex with fatal neonatal melioidosis although was not statistically significant (P = .2127), there could be an underlying biological significance given the consistently reported higher incidence in male across the age groups.…”

Section: Discussionmentioning

confidence: 99%

Neonatal melioidosis case reports—Lessons learned

Daim

Barnad

Johnny³

et al. 2019

Clinical Case Reports

View full text Add to dashboard Cite

In endemic regions, include melioidosis in the routine differential diagnosis of neonates with respiratory distress, and consider early empirical ceftazidime treatment for neonates with worsening respiratory distress. K E Y W O R D SBurkholderia pseudomallei, ceftazidime, melioidosis, neonatal, Sabah Malaysia How to cite this article: Daim S, Barnad E, Johnny V, et al. Neonatal melioidosis case reports-Lessons learned. Clin Case Rep. 2020;8:171-175. https ://doi.

show abstract

“…Management is difficult as B. pseudomallei is intrinsically resistant to many antibiotics and typically treatment requires at least 2 weeks of intravenous antibiotic therapy followed by lengthy oral therapy, often with multiple antibiotics [1,5]. Despite efficacious antibiotic therapy being available, there is still significant mortality and morbidity, and there is no guarantee of clinical success, often due to severe forms of the disease [6]. Furthermore, this brings up the potential for prolonged latent disease, which represents a future problem for the individual infected.…”

Section: Introductionmentioning

confidence: 99%

The treatment of melioidosis: is there a role for repurposed drugs? A proposal and review

Laws

Taylor

Russell

et al. 2019

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

Introduction: Melioidosis is a significant health problem within endemic areas such as Southeast Asia and Northern Australia. The varied presentation of melioidosis and the intrinsic antibiotic resistance of Burkholderia pseudomallei, the causative organism, make melioidosis a difficult infection to manage. Often prolonged courses of antibiotic treatments are required with no guarantee of clinical success. Areas covered: B. pseudomallei is able to enter phagocytic cells, affect immune function, and replicate, via manipulation of the caspase system. An examination of this mechanism, and a look at other factors in the pathogenesis of melioidosis, shows that there are multiple potential points of therapeutic intervention, some of which may be complementary. These include the directed use of antimicrobial compounds, blocking virulence mechanisms, balancing or modulating cytokine responses, and ameliorating sepsis. Expert commentary: There may be therapeutic options derived from drugs in clinical use for unrelated conditions that may have benefit in melioidosis. Key compounds of interest primarily affect the disequilibrium of the cytokine response, and further preclinical work is needed to explore the utility of this approach and encourage the clinical research needed to bring these into beneficial use.

show abstract

Characteristics, clinical outcomes and factors influencing mortality of patients with melioidosis in southern Thailand: A 10-year retrospective study

Abstract: Melioidosis is not uncommon in southern Thailand. The mortality of patients with pneumonia, bacteremia and septic shock is relatively high. Appropriate antibiotics, initially, will improve outcomes.

Cited by 38 publications

References 27 publications

Hepatic/splenic abscess and/or skin and soft tissue infection as predictors of melioidosis in children

Hepatic/splenic abscess and/or skin and soft tissue infection as predictors of melioidosis in children

Neonatal melioidosis case reports—Lessons learned

The treatment of melioidosis: is there a role for repurposed drugs? A proposal and review

Contact Info

Product

Resources

About