Management of melioidosis osteomyelitis and septic arthritis

Shetty, Raviraj; Mathew, Manoj; Smith, J.; Morse, Levi; Mehta, Janak A.; Currie, Bart J.

doi:10.1302/0301-620x.97b2.34799

Cited by 27 publications

(48 citation statements)

References 33 publications

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“…Skin and soft-tissue melioidosis was more involved as a primary or secondary infection in this report, as well as in other studies [11][12][13][14][15]. In the same study done by Pui and Tan [14], the knee was the most common infected location, followed by ankle, foot, shoulder, and hip; these results agree with our findings and those of other reports [10].…”

Section: Discussionsupporting

confidence: 93%

“…The predomination of male gender among osteoarticular melioidosis was also reported in the literature about bone and soft-tissue melioidosis [1,10]. Another risk factor reported in this study was diabetes mellitus, which has been reportd to be the superior predisposing factor for melioidosis worldwide.…”

Section: Discussionsupporting

confidence: 81%

“…Pediatric melioidosis is uncommon in endemic areas [10]; no cases of pediatric melioidosis were reported here, which might be attributed to the lack of predisposing factors such as those in adults.…”

Section: Discussionmentioning

confidence: 55%

“…However, septic arthritis and osteomyelitis can be the primary manifestations of melioidosis [10]. In this study, bone and joint infection due to secondary melioidosis were reported in six patients, occurring as a consequence of bacteremic multifocal or localized disease, whereas in three patients, bone and/or joint were the primary sites of melioidosis.…”

Section: Discussionmentioning

confidence: 65%

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Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent

Zueter

Abumarzouq

Yusof

et al. 2017

J Infect Dev Ctries

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Introduction: Melioidosis involving bone, joints, and soft tissue is rare and reported usually following dissemination of disease from infection elsewhere in the body; to a lesser degree, it can also be reported as the primary manifestation of melioidosis. Methodology: The orthopedic registry at Hospital University Sains Malaysia from 2008 until 2014 was retrospectively reviewed and was followed by molecular typing of Burkholderia pseudomallei. Results: Out of 20 cases identified, 19 patients were confirmed to have osteoarticular and/or soft-tissue melioidosis. The majority of the patients were males (84%), and 16 patients had underlying diabetes mellitus with no significant estimated risk with the disease outcomes. Bacterial genotype was not associated with the disease as a risk. Death was a significant outcome in patients with bacteremic infections (p = 0.044). Conclusion: Patients with lung or skin melioidosis require careful treatment follow-up to minimize the chance for secondary osteoarticular infection. Human risk factors remain the leading predisposing factors for melioidosis. Early laboratory and clinical diagnosis and acute-phase treatment can decrease morbidity and mortality.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 65%

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Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent

Zueter

Abumarzouq

Yusof

et al. 2017

J Infect Dev Ctries

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“…[9] A recent study from Australia has suggested that 25.4% patients presented with septic arthritis suggesting that bone and joint involvement is becoming a common presentation of melioidosis. [10] Among joints, knee joints are the most commonly affected joints, followed by ankle, hip, and shoulder joints. These patients also have elevated erythrocyte sedimentation rate, C-reactive protein, renal and liver functions similar to our patient.…”

Section: Discussionmentioning

confidence: 99%

Melioidosis: An emerging infection with fatal outcomes

Princess¹,

Ebenezer

Ramakrishnan

et al. 2017

Indian Journal of Critical Care Medicine

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According to the Centers for Disease Control and Prevention, from being nonendemic for melioidosis, India has now become endemic for the disease since 2012. Until then, melioidosis cases were being reported sporadically from India. There have been isolated case reports from few states across the country for the past few years. Most of the times, Burkholderia pseudomallei may be misreported as Pseudomonas species, especially in resource-poor laboratories. Due to its varied clinical presentation, the specific clinical diagnosis can be difficult, thereby making laboratory diagnosis mandatory. This could make a huge impact on patient care as this organism has a different treatment protocol as well as virulence determinants which influence the course of management. Although known for its endemicity in Australia, Thailand, and other Southeast Asian countries, B. pseudomallei has emerged in new areas such as India, Southern China, Brazil, and Malawi. We present a rare case of melioidosis with rapid disease progression to fatal outcome from Chennai, South India.

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Burkholderia Pseudomallei Causing Bone and Joint Infections: A Clinical Update

Raja

Scarsbrook

2016

Infect Dis Ther

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Burkholderia pseudomallei (B. pseudomallei), a causative agent of an emerging infectious disease melioidosis, is endemic in the tropical regions of the world. Due to increased international travel, the infection is now also seen outside of the tropics. The majority of patients with identified risk factors such as diabetes mellitus, heavy alcohol use, malignancy, chronic lung and kidney disease, corticosteroid use, thalassemia, rheumatic heart disease, systemic lupus erythematosus and cardiac failure acquire this organism through percutaneous inoculation or inhalation. The clinical manifestations are variable, ranging from localized abscess formation to septicemia. Melioidotic bone and joint infections are rarely reported but are an established entity. The knee joint is the most commonly affected joint in melioidosis, followed by the ankle, hip and shoulder joints. Melioidosis should be in the differential diagnosis of bone and joint infections in residents or returning travelers from the endemic area. Melioidosis diagnosis is missed in many parts of the world due to the lack of awareness of this infection and limited laboratory training and diagnostic techniques. It also mimics other diseases such as tuberculosis. Delay in the diagnosis, or the initiation of appropriate and effective treatment against melioidosis, could worsen the outcome. Initial therapy with ceftazidime, or carbapenem with or without cotrimoxazole is recommended, followed by the oral eradication therapy (based on the antimicrobial susceptibility) with amoxicillin/clavulanic acid or cotrimoxazole. Surgical intervention remains important. This paper reviews current literature on the epidemiology, clinical features, diagnosis, and management of melioidotic bone and joint infections.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-015-0098-2) contains supplementary material, which is available to authorized users.

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Management of melioidosis osteomyelitis and septic arthritis

Cited by 27 publications

References 33 publications

Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent

Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent

Melioidosis: An emerging infection with fatal outcomes

Burkholderia Pseudomallei Causing Bone and Joint Infections: A Clinical Update

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