Melioidosis mimicking primary lung malignancy with superior vena cava obstruction

Wilson, Malcolm; Smith, Simon; Brown, James S.; Hanson, Joshua

doi:10.1016/j.idcr.2016.09.014

Cited by 4 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, chronic pulmonary mass lesions in patients with melioidosis may be misdiagnosed as lung cancer. 28,29 However, those clinical presentations, risk factors, and the possible misdiagnosis as cancer were also observed in unhealthy patients who might present with a form of chronic melioidosis. 30,31 Therefore, further studies are needed to determine the cause of death or any unhealthy conditions in seropositive patients with melioidosis.…”

Section: Resultsmentioning

confidence: 99%

Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam

Tran

Nguyen

Pham

et al. 2022

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Melioidosis is a fatal infectious disease in the tropics and subtropics. Currently, bacterial culture is the gold standard for diagnosis of the disease, but its sensitivity is relatively low. In this study, we evaluated four ELISAs using sera collected from culture-confirmed cases of melioidosis (n = 63), cases with other bacterial infections (n = 62), and healthy donors (n = 60). Antigens used for ELISAs were the whole-cell (WC) antigens and recombinant proteins of hemolysis co-regulated protein 1 (Hcp1), GroEL1, and alkyl hydroperoxide reductase subunit C (AhpC). Using the cutoff values for optical density at 490 nm defined at a specificity of > 95%, the sensitivity of the WC, Hcp1, GroEL1, and AhpC ELISAs was 93.7%, 87.3%, 61.9%, and 57.1%, respectively. The combined WC/Hcp1 ELISA showed the greatest sensitivity and specificity of 98.4% and 95.1%, respectively. Of 511 and 500 sera collected from clinically suspected febrile patients admitted to the General Hospital of Ha Tinh Province and the Hue Central Hospital, respectively, combined WC/Hcp1 ELISAs showed 52 (10.2%) and 41 (8.2%) patients positive for melioidosis, respectively. The assay detected 14 of 14 (100%) and 21 of 23 (91.3%) culture-confirmed cases of melioidosis at Ha Tinh and Hue, respectively. A follow-up study of 38 patients positive for melioidosis by combined WC/Hcp1 ELISAs but negative for Burkholderia pseudomallei by culture method or not assigned to examine for bacterial culture resulted in 2 (5.3%) culture-reconfirmed patients with melioidosis, 9 (23.7%) deaths, 17 (44.7%) unhealthy patients, and 10 (26.3%) healthy persons. Combined WC/Hcp1 ELISA was a reliable serological method to detect underdiagnosed cases of melioidosis. Further investigations are needed to estimate the true sensitivity and specificity of the assay and the true number of cases of melioidosis.

show abstract

Section: Resultsmentioning

confidence: 99%

Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam

Tran

Nguyen

Pham

et al. 2022

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…Mediastinal melioidosis can mimic the presentation of primary lung malignancy. 6 , 7 , 8 In each of the four cases presented, a presumptive diagnosis of malignancy had been made and this suspicion was communicated to patients. Factors which contributed to this diagnostic bias include the smoking history, the chronicity of symptoms, and the radiological reporting of chest imaging findings.…”

Section: Discussionmentioning

confidence: 99%

“…Mediastinal melioidosis can mimic the presentation of primary lung malignancy 6–8 . In each of the four cases presented, a presumptive diagnosis of malignancy had been made and this suspicion was communicated to patients.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal melioidosis: A case series from far North Queensland

Gadsby

Oaten

Davies

et al. 2022

Respirology Case Reports

View full text Add to dashboard Cite

Melioidosis is the clinical disease caused by the Gram‐negative bacillus Burkholderia pseudomallei and is endemic to Northern Australia and Southeast Asia. It is commonly referred to as the ‘great mimicker’ because of its wide range of clinical presentations, often making diagnosis challenging. Isolated mediastinal lymphadenopathy as the presenting feature of melioidosis is rare and can be indistinguishable from tuberculosis or malignancy. Endobronchial ultrasound (EBUS) is the preferred technique for evaluating undifferentiated mediastinal lymphadenopathy but its role in the diagnosis of mediastinal melioidosis remains sparsely reported in the literature. In this case series, we present four cases of mediastinal melioidosis, and the role that EBUS guided fine needle aspiration (FNA) played in the diagnosis and management.

show abstract

“…The diagnosis of melioidosis is usually difficult due to various and nonspecific clinical presentation. Generally, melioidosis is considered a great mimicker because it can cause chronic cavitary lesions mimicking reactivation of tuberculosis, a mass-like lesion leading to superior vena cava obstruction mimicking lung cancer, 7 and acute fatal pneumonia similar to other infections. 8 According to the previous study in northeastern Thailand, melioidosis accounted for 20% of community-acquired sepsis, with mortality rate of 35–40%.…”

Section: Discussionmentioning

confidence: 99%

<p>Non-Small Cell Lung Carcinoma with Concomitant Localized Pulmonary Melioidosis: A Rare Co-Existing Disease</p>

Laplertsakul

Sutherasan

Suwatanapongched

et al. 2020

IDR

View full text Add to dashboard Cite

Melioidosis is caused by Burkholderia pseudomallei, water-and-soil gramnegative bacteria predominantly found in Southeast Asia and Australia. Herein, we reported a 63-year-old Thai man presenting with prolonged fever, non-productive cough, and weight loss for 3 months. He underwent deceased donor kidney transplantation 4 years ago and was on many immunosuppressive agents after transplantation. At presentation, his chest radiograph showed a mass-like lesion in the left upper lobe. Histopathological examination of a transthoracic needle lung biopsy yielded adenocarcinoma, while tissue culture grew for B. pseudomallei. He was diagnosed with stage IIIA non-small cell lung cancer (T4N0M0) co-existing with localized pulmonary melioidosis. After intensive and eradication therapy for melioidosis, his well-being improved with the resolution of fever. He sequentially underwent left upper lobectomy, but the procedure was not accomplished due to severe adhesions surrounding the left lung and great vessels. After surgery, he received concurrent chemoradiation therapy for his lung cancer. Nevertheless, the disease progressed, and he finally passed away. Since fever is not a common manifestation of lung cancer, co-existing infection, such as tuberculosis, fungal infection, and melioidosis, should always be excluded in patients suspected of having lung cancer presenting with unexplained fever.

show abstract

Melioidosis mimicking primary lung malignancy with superior vena cava obstruction

Cited by 4 publications

References 3 publications

Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam

Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam

Mediastinal melioidosis: A case series from far North Queensland

<p>Non-Small Cell Lung Carcinoma with Concomitant Localized Pulmonary Melioidosis: A Rare Co-Existing Disease</p>

Contact Info

Product

Resources

About