Neuromelioidosis: a series of seven cases in Hainan province, China

Zhan, Yongli; Wu, Yehua; Yu, Anle

doi:10.1177/0300060516685967

Cited by 11 publications

(7 citation statements)

References 19 publications

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“…Furthermore, it was also detected in some patients whose serum showed positive for an antibody against B. pseudomallei in Guangdong with the positive rate was 6.1% in 1988 [ 5 ]. Subsequently, sporadic melioidosis cases have been reported in Hainan province and Zhanjiang, Guangdong province [ 7 , 8 ], with a recent clinical study in Hainan showing an increased incidence of melioidosis being reported in this region [ 9 ]. However, cases were rarely reported in Guangdong province over the most recent 5 years, which may result from lacking of recognition and underreporting .…”

Section: Introductionmentioning

confidence: 99%

First co-infection case of melioidosis and Japanese encephalitis in China

Chen³

et al. 2018

BMC Infect Dis

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BackgroundMelioidosis is endemic in Southeast Asia and northern Australia. Infection usually follows percutaneous inoculation or inhalation or ingestion of the causative bacterium, Burkholderia pseudomallei, which is present in soil and surface water in endemic regions. Japanese encephalitis (JE) is a vector-borne viral zoonosis caused by Japanese encephalitis virus (JEV), leading to epidemic encephalitis in Southeast Asia. Both B. pseudomallei and JEV have spread dominantly in the Hainan and Guangdong provinces in China. Here we reported the first case of co-infection of B. pseudomallei and JEV, which was discovered in Huizhou in the Guangdong province in June 2016.Case presentationA 52-year-old man was admitted to the hospital with acute febrile illness and headache, diagnosed as respiratory infection, central nervous system (CNS) infection, septicemia, and hepatic dysfunction. Based on B. pseudomallei-positive blood and cerebrospinal fluid (CSF) cultures, the patient was diagnosed with melioidosis and treated aggressively with antibiotics. However, the patient failed to make a full recovery. Further laboratory tests focused on CNS infection were conducted. The co-infection of B. pseudomallei and JEV was confirmed after the positive IgM antibodies of JEV were detected in both CSF and blood. After diagnosis of co-infection with B. pseudomallei and JEV, the patient was provided supportive care in hospital and recovered after approximately 3 weeks.ConclusionGiven the possibility of co-infection of B. pseudomallei and JEV, as well as variable case presentations, it is critical to enhance the awareness, detection, and treatment of co-infection in regard to melioidosis.

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Section: Introductionmentioning

confidence: 99%

First co-infection case of melioidosis and Japanese encephalitis in China

Chen³

et al. 2018

BMC Infect Dis

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“…Furthermore, a case report by Arif et al demonstrates a man in his 30s with peripheral neuropathy secondary to melioidosis 23. Few other rare presentations of neuromelioidosis reported are cerebral/dural(sagittal) sinus thrombosis and mimicking acute transverse myelitis 20 24 25…”

Section: Discussionmentioning

confidence: 99%

Critical approach to atypical spectrum of melioidosis: a case-series based literature review

et al. 2022

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Melioidosis is an emerging infectious disease with highest predominance in Southeast Asia, but it has a significantly lower incidence across other parts of the globe. The most common systemic involvement seen in melioidosis is pulmonary, followed by multiple visceral and cutaneous abscesses. Infrequently, melioidosis manifests with atypical presentations such as spontaneous bacterial peritonitis (SBP), acute pyogenic meningitis or septic arthritis. Our primary case discusses an extremely rare presentation of melioidosis with SBP. There have not been any cases of SBP reported secondary to melioidosis infection. The second case exhibits development of acute pyogenic meningitis from haematogenous dissemination of this organism, while the final case demonstrates musculoskeletal melioidosis as an uncommon presentation. Of note, this case series also discusses the guidelines of management of melioidosis and illustrates the tremendous impact of appropriate and timely antibiotic therapy on mortality and morbidity secondary to melioidosis.

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“…MRI features of CNS melioidosis include rim enhancing cerebral microabscesses, which may be rounded or tubular in morphology. Nevertheless, other CNS infections can present with similar microabscess morphology including toxoplasmosis, neurocysticercosis, and tuberculosis [15], [16]. However, the propensity to spread along and involve white matter tracts across the commissural and projection fibers to the contralateral hemisphere is another distinguishing feature of neuromelioidosis.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Neuromelioidosis in Asia-Pacific: A Systematic Review

Zamzuri

Jamhari

Nawi

et al. 2021

Open Access Maced J Med Sci

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Introduction: Neuromelioidosis is a rare complication of melioidosis caused by Burkholderia pseudomallei, a Gram-negative bacterium commonly found in soil and surface water. Although cerebral involvement of melioidosis comprises only 4% of total complications, it significantly impacts mortality and morbidity. This study aims to perform a systematic review on various neurological complications of melioidosis in the Asia-Pacific region within the previous 5 years. Method: Systematic search was performed in PubMed, Web of Science databases and Google Scholar on neuromelioidosis complications published from 2015-2019. Results: Central nervous system (CNS) complications comprise 5% of all cases of melioidosis. 16 selected articles were analysed based on its risk factors like diabetes mellitus, chronic renal and lung disease, alcohol abuse, and immunosuppression. Neuromelioidosis is detected 6-14 days after the first presentation and confirmed by detailed investigations. Radioimaging helps to differentiate neuromelioidosis from other diagnoses such as meningitis or brain abscess. The majority of literature recommended 2-week intensive Ceftazidime or Meropenem therapy, followed by 3–6 months Trimethoprim and Sulfamethoxazole oral eradication therapy. Conclusion: Neuromelioidosis is rare, with relatively nonspecific CNS clinical features. Patients or travelers from endemic areas with risk factors should be treated cautiously. Radioimaging modalities aid early microbiological sampling and appropriate antibiotic therapy.

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Neuromelioidosis: a series of seven cases in Hainan province, China

Cited by 11 publications

References 19 publications

First co-infection case of melioidosis and Japanese encephalitis in China

First co-infection case of melioidosis and Japanese encephalitis in China

Critical approach to atypical spectrum of melioidosis: a case-series based literature review

Epidemiology of Neuromelioidosis in Asia-Pacific: A Systematic Review

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