Clinical and epidemiological profile of melioidosis in a tertiary care teaching hospital from South India

Jose, Rosmi; Valsan, Chithra; Sathiavathy, KA

doi:10.18231/j.ijmmtd.2019.023

Cited by 2 publications

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“…Mostly, bacteremic patients will have high white blood cell counts due to bacteria's presence in the blood. A study conducted in South Indian state Kerala reported that the overall mortality was 24.3%, and it was 40% among bacteremic cases and 13.6% among non-bacteremic melioidosis [40] …”

Section: Discussionmentioning

confidence: 99%

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The Cox model of predicting mortality among melioidosis patients in Northern Malaysia

et al. 2021

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Melioidosis is an infectious disease that is initiated by a bacteria recognized as Burkholderia pseudomallei . Despite the high fatality rate from melioidosis, there is a minimal published study about the disease in Malaysia. This study aimed to identify the prognostic factors of mortality among melioidosis patients in northern Malaysia. All inpatient patients who were admitted to Hospital Sultanah Bahiyah, Kedah and Hospital Tuanku Fauziah, Perlis with culture-confirmed melioidosis during the period 2014 to 2017 were included in the study. The study retrospectively collected 510 melioidosis patients from the Melioidosis Registry. Hazard ratio (HR) used in advanced multiple Cox regression was used to obtain the final model of prognostic factors of melioidosis. The analysis was performed using STATA/SE 14.0 for Windows software. From the results, among the admitted patients, 50.1% died at the hospital. The mean age for those who died was 55 years old, and they were mostly male. The most common underlying disease was diabetes mellitus (69.8%), followed by hypertension (32.7%). The majority of cases (86.8%) were bacteremic. The final Cox model identified 5 prognostic factors of mortality among melioidosis patients. The factors were diabetes mellitus, type of melioidosis, platelet count, white blood cell count, and urea value. The results showed that bacteremic melioidosis increased the risk of dying by 3.47 (HR: 3.47, 95% confidence intervals [CI]: 1.67–7.23, P = .001) compared to non-bacteremic melioidosis. Based on the blood investigations, the adjusted HRs from the final model showed that all 3 blood investigations were included as the prognostic factors for the disease (low platelet: HR = 1.76, 95% CI: 1.22–2.54, P = .003; high white blood cell: HR = 1.49, 95% CI 1.06–2.11, P = .023; high urea: HR = 2.92, 95% CI: 1.76–4.85, P < .001; and low level of urea: HR = 2.69, 95% CI: 1.69–4.29, P < .001). By contrast, melioidosis patients with diabetic had 30.0% lower risk of dying from melioidosis compared to those with non-diabetic (HR = 0.70, 95% CI: 0.52–0.94, P = .016). Identifying the prognostic factors of mortality in patients with melioidosis allows a guideline of early management in these patients, which may improve patient's survival.

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Section: Discussionmentioning

confidence: 99%

“…A study conducted in South Indian state Kerala reported that the overall mortality was 24.3%, and it was 40% among bacteremic cases and 13.6% among non-bacteremic melioidosis. [40] 4.1. Limitation…”

Section: Multivariable Analysismentioning

confidence: 99%

The Cox model of predicting mortality among melioidosis patients in Northern Malaysia

et al. 2021

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“…Hence the true incidence of the disease is unknown, and it may vary from state to state with a few hotspots within the same state. For the past few decades, India has faced increased case reports of melioidosis especially in the southern coastal regions including Malabar region of Kerala, Karnataka, Maharashtra, Tamil Nadu and Pondicherry [1,4,6,[11][12][13][14][15]. There are quite a few studies on the isolation of B. pseudomallei from soil from coastal regions of South India including Karnataka and Tamil Nadu, indicating that this organism could be endemic there although few cases have been reported.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A rare and fatal case of tubo-ovarian abscess due to Burkholderia pseudomallei presenting as puerperal sepsis

Bhaskar M,

Rajamanikam,

Raj

et al. 2023

Access Microbiology

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Introduction. Melioidosis is an emerging life-threatening infectious disease caused by the Gram-negative Burkholderia pseudomallei found in contaminated soil and surface ground water. It often presents with varied clinical manifestations and has a high mortality if left untreated due to lack of clinical suspicion. Here we report a rare and fatal case of tubo-ovarian abscess presenting as puerperal sepsis due to B. pseudomallei in a young woman. Case report. A 25-year-old female presented for medical consultation at day 43 postpartum complaining of fever on and off for the past 40 days associated with vomiting. On per speculum examination, greenish discharge from the cervix was seen and a right adnexal mass was felt which was cystic in consistency, non-tender and pushing the cervix to the left side. An exploratory laparotomy was carried out and pus was drained from below the rectus sheath, and from the right tubo-ovarian mass. Peripheral blood and the pus samples collected intraoperatively grew B. pseudomallei . The patient died on the fifth post-operative day due to septic shock with disseminated intravascular coagulation secondary to puerperal sepsis. Conclusion. Melioidosis is a fatal but treatable disease when it is promptly diagnosed. In countries such as India, where tuberculosis is highly endemic, underdiagnosis of melioidosis can be common. Clinicians and microbiologists should have a high index of suspicion of melioidosis especially in individuals with underlying illness.

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Clinical and epidemiological profile of melioidosis in a tertiary care teaching hospital from South India

Cited by 2 publications

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The Cox model of predicting mortality among melioidosis patients in Northern Malaysia

The Cox model of predicting mortality among melioidosis patients in Northern Malaysia

A rare and fatal case of tubo-ovarian abscess due to Burkholderia pseudomallei presenting as puerperal sepsis

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