Displaying publications 1 - 20 of 55 in total

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  1. Zulkiflee AB, Prepageran N, Philip R
    Am J Otolaryngol, 2008 Jan-Feb;29(1):72-4.
    PMID: 18061838 DOI: 10.1016/j.amjoto.2007.02.004
    INTRODUCTION: Melioidosis is a life-threatening disease caused by B. pseudomallei. It is endemic in Southeast Asia with a few reports from the Western world. It is transmitted via inhalation, ingestion or direct contact with an open wound. Clinically it may present with local or systemic symptoms. Mortality rate is very high in systemic disease; but local infection is usually mild, which causes delay in seeking medical attention.
    CASE REPORT: We report a case of neck melioidosis presenting as a parapharyngeal abscess that was successfully managed with incision and drainage and intravenous ceftazidime and co-trimoxazole for 6 weeks followed by eradication therapy with oral co amoxiclav.
    CONCLUSION: Neck melioidosis must be considered one of differential diagnoses for "cold abscesses" of the neck, especially in an endemic area, in Asian migrants, or in those with history of previous visit from the endemic regions.
    Matched MeSH terms: Melioidosis/diagnosis
  2. Sam IC, Puthucheary SD
    Ann Trop Paediatr, 2006 Sep;26(3):219-24.
    PMID: 16925959
    There are few data on paediatric melioidosis in endemic areas outside rural north-eastern Thailand and northern Australia. This study reports 16 culture-confirmed cases of melioidosis in children aged < or = 15 years seen between 1976 and 2005 at an urban teaching hospital in Kuala Lumpur, Malaysia. Seven (43.8%) patients had septicaemic melioidosis (with three known deaths) and nine (56.2%) had localised disease (one death). Eleven (68.8%) patients had underlying diseases, including five with haematological malignancies. Skin, soft tissue and lymph nodes were most commonly affected. There were no cases of parotitis or pharyngocervical disease (seen in Thailand), or encephalomyelitis (seen in Australia). The differences in disease seen in this study compared with the mostly rural patients described in previous studies might be owing to a different patient population in an urban environment. Septicaemic melioidosis has a high mortality, but localised disease has a good prognosis, and selected cases may be cured without the full recommended treatment regimen.
    Matched MeSH terms: Melioidosis/diagnosis*
  3. Hara Y, Chin CY, Mohamed R, Puthucheary SD, Nathan S
    BMC Infect Dis, 2013;13:165.
    PMID: 23556548 DOI: 10.1186/1471-2334-13-165
    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic to Southeast Asia and northern Australia. Clinical manifestations of disease are diverse, ranging from chronic infection to acute septicaemia. The current gold standard of diagnosis involves bacterial culture and identification which is time consuming and often too late for early medical intervention. Hence, rapid diagnosis of melioidosis is crucial for the successful management of melioidosis.
    Matched MeSH terms: Melioidosis/diagnosis*
  4. Mariappan V, Thavagnanam S, Vellasamy KM, Teh CJS, Atiya N, Ponnampalavanar S, et al.
    BMC Infect Dis, 2018 Sep 05;18(1):455.
    PMID: 30185168 DOI: 10.1186/s12879-018-3371-7
    BACKGROUND: Burkholderia pseudomallei is the causative agent of melioidosis, which is a potentially life threatening disease endemic in Southeast Asian countries. In Malaysia, cystic fibrosis (CF) is an uncommon condition. The association between CF and B.pseudomallei infections has been reported previously. However, this is the first case report of a pediatric melioidosis relapse and co-infection with other Gram-negative bacteria in Malaysia.

    CASE PRESENTATION: A 14-year-old Chinese Malaysian boy presented with a history of recurrent pneumonia, poor growth and steatorrhoea since childhood, and was diagnosed with CF. B. pseudomallei was cultured from his sputum during three different admissions between 2013 and 2016. However, the patient succumbed to end stage of respiratory failure in 2017 despite antibiotics treatment against B.pseudomallei. The isolates were compared using multilocus-sequence typing and repetitive-element polymerase chain reaction (PCR), and confirmed that two of the isolates were of same sequence type, which may indicate relapse.

    CONCLUSIONS: CF patients should be aware of melioidosis in endemic regions, as it is an emerging infectious disease, especially when persistent or recurrent respiratory symptoms and signs of infection occur. The high prevalence rates of melioidosis in Malaysia warrants better management options to improve quality of life, and life expectancy in patients with CF. Travel activities to endemic regions should also be given more consideration, as this would be crucial to identify and initiate appropriate empiric treatment.

    Matched MeSH terms: Melioidosis/diagnosis*
  5. Chang CY, Lau NLJ, Currie BJ, Podin Y
    BMC Infect Dis, 2020 Mar 06;20(1):201.
    PMID: 32143598 DOI: 10.1186/s12879-020-4937-8
    BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy.

    CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood.

    CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.

    Matched MeSH terms: Melioidosis/diagnosis*
  6. Shrestha N, Adhikari M, Pant V, Baral S, Shrestha A, Basnyat B, et al.
    BMC Infect Dis, 2019 Feb 19;19(1):176.
    PMID: 30782129 DOI: 10.1186/s12879-019-3793-x
    BACKGROUND: Melioidosis is a life-threatening infectious disease that is caused by gram negative bacteria Burkholderia pseudomallei. This bacteria occurs as an environmental saprophyte typically in endemic regions of south-east Asia and northern Australia. Therefore, patients with melioidosis are at high risk of being misdiagnosed and/or under-diagnosed in South Asia.

    CASE PRESENTATION: Here, we report two cases of melioidosis from Nepal. Both of them were diabetic male who presented themselves with fever, multiple abscesses and developed sepsis. They were treated with multiple antimicrobial agents including antitubercular drugs before being correctly diagnosed as melioidosis. Consistent with this, both patients were farmer by occupation and also reported travelling to Malaysia in the past. The diagnosis was made consequent to the isolation of B. pseudomallei from pus samples. Accordingly, they were managed with intravenous meropenem followed by oral doxycycline and cotrimoxazole.

    CONCLUSION: The case reports raise serious concern over the existing unawareness of melioidosis in Nepal. Both of the cases were left undiagnosed for a long time. Therefore, clinicians need to keep a high index of suspicion while encountering similar cases. Especially diabetic-farmers who present with fever and sepsis and do not respond to antibiotics easily may turn out to be yet another case of melioidosis. Ascertaining the travel history and occupational history is of utmost significance. In addition, the microbiologist should be trained to correctly identify B. pseudomallei as it is often confused for other Burkholderia species. The organism responds only to specific antibiotics; therefore, correct and timely diagnosis becomes crucial for better outcomes.

    Matched MeSH terms: Melioidosis/diagnosis*
  7. Bodilsen J, Langgaard H, Nielsen HL
    BMJ Case Rep, 2015 Jan 16;2015.
    PMID: 25596295 DOI: 10.1136/bcr-2014-207340
    A healthy Danish man presented with infected prepatellar bursitis 8 months after being involved in a car accident in Malaysia resulting in exposure of a laceration of his knee to stagnant water. Tissue samples grew Burkholderia pseudomallei and diagnostic work up revealed no secondary foci. The patient was successfully treated with surgical debridement and 3 months of oral trimethoprim-sulfamethoxazole. At 6 months follow-up the patient was without relapse.
    Matched MeSH terms: Melioidosis/diagnosis*
  8. Auvens C, Neuwirth C, Piroth L, Blot M
    BMJ Case Rep, 2019 May 22;12(5).
    PMID: 31122956 DOI: 10.1136/bcr-2018-228856
    Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.
    Matched MeSH terms: Melioidosis/diagnosis*
  9. Che Rahim MJ, Mohammad N, Kamaruddin MI, Wan Ghazali WS
    BMJ Case Rep, 2019 Jul 01;12(7).
    PMID: 31266760 DOI: 10.1136/bcr-2019-229974
    We reported a case of a young female patient presented with sepsis and diagnosed with melioidosis and systemic lupus erythematosus (SLE) within the same admission. She presented with 1-week history of productive cough, progressive dyspnoea together with prolonged fever, arthralgia, rashes and oral ulcers. She had septicemic shock, respiratory failure requiring intubation and ventilation in intensive care unit and subsequently developed acute renal failure requiring haemodialysis. Antibiotics and immunosuppressive treatment including low-dose intravenous cyclophosphamide were commenced. She had a remarkable recovery and was discharged after 6 weeks. There was no evidence of active SLE or relapse of melioidosis during clinic follow-ups.
    Matched MeSH terms: Melioidosis/diagnosis*
  10. Ong SCL, Alemam MMM, Zakaria NA, Abdul Halim NA
    BMJ Case Rep, 2017 Oct 19;2017.
    PMID: 29054959 DOI: 10.1136/bcr-2017-222342
    Melioidosis is endemic in Southeast Asia and tropical Australia with varying clinical features from benign skin lesions to fatal septicaemia. Imaging plays an important role in evaluation of the melioid liver abscesses. A 45-year-old man with underlying diabetes presented with fever and lethargy for 2 weeks and abdominal pain for 2 days. His liver was enlarged on examination. Blood investigations revealed mild leucocytosis and raised liver enzymes. Ultrasound showed multiple multiloculated hypoechoic lesions throughout the liver and spleen. CT of abdomen confirmed that some liver lesions were made up of asymmetric locules of varying sizes (honeycomb sign), while others had hypodense centre with small symmetric peripheral locules in radial fashion (necklace sign). Blood culture was positive for Burkholderia pseudomallei He was subsequently treated with ceftazidime for a month followed by oral trimethoprim-sulfamethoxazole for 3 months. Follow-up CT of abdomen a month after diagnosis and treatment showed resolving hepatic and splenic lesions.
    Matched MeSH terms: Melioidosis/diagnosis*
  11. Rodríguez JY, Álvarez-Moreno CA, Cortés JA, Rodríguez GJ, Esquea K, Pinzón H, et al.
    Biomedica, 2019 05 01;39:10-18.
    PMID: 31529845 DOI: 10.7705/biomedica.v39i3.4534
    Melioidosis is an infectious disease caused by Burkholderia pseudomallei whose clinical diagnosis can be difficult due not only to its varied clinical presentation but also to the difficulties in the microbiological diagnosis.Thus, it may be necessary to use molecular techniques for its proper identification once it is suspected.
    There are few antibiotics available for the treatment of this disease, which must be used over a long period of time. Although it is known to be endemic in Thailand, Malaysia, Singapore, Vietnam, and Australia, in Colombia there are few reported cases.
    We describe a case of melioidosis in the northern region of Colombia. Additionally, we review its clinical characteristics and treatment and we describe the local epidemiology of this disease.
    Matched MeSH terms: Melioidosis/diagnosis
  12. Ganesan D, Puthucheary SD, Waran V
    Br J Neurosurg, 2003 Dec;17(6):568-71.
    PMID: 14756491
    Central nervous system melioidosis is an unusual infection in humans. This article reports a case of melioidosis presenting as an acute spinal epidural abscess. A discussion of this case and its management together with a brief review of melioidosis of the central nervous system is presented.
    Matched MeSH terms: Melioidosis/diagnosis*
  13. Wang CY, Yap BH, Delilkan AE
    Chest, 1993 Jun;103(6):1897-9.
    PMID: 8404124
    We present the case of a 24-year-old woman with acute septicemic melioidosis resulting from inhaled infective dust during a blast injury. With appropriate antibiotic treatment and supportive therapy in the ICU, the patient made an uneventful recovery.
    Matched MeSH terms: Melioidosis/diagnosis
  14. Lin HP, Puthucheary SD, Sinniah D
    Clin Pediatr (Phila), 1980 Oct;19(10):697-9.
    PMID: 6931670
    A 13-year old boy with acute lymphoblastic leukemia on chemotherapy developed neutropenia and acute cellulitis progressing to fulminating septicemia due to Pseudomonas pseudomallei. Septicemic melioidosis should be considered in the differential diagnosis of a febrile illness in children who are susceptible to infections.
    Matched MeSH terms: Melioidosis/diagnosis
  15. Francis A, Aiyar S, Yean CY, Naing L, Ravichandran M
    Diagn Microbiol Infect Dis, 2006 Jun;55(2):95-9.
    PMID: 16626918
    Isolation and culture of Burkholderia pseudomallei remains the main stay in the diagnosis of melioidosis. Thus, the search for selective and differential media for B. pseudomallei has been ongoing. A number of such media have been reported with varying efficacy. Ashdown medium is the most established selective medium for the isolation of B. pseudomallei. There are no reports of differential media differentiating B. pseudomallei from Burkholderia cepacia. This report documents such a selective and differentiating medium for B. pseudomallei. Of a total of 1042 clinical specimens containing mixed flora and gram-negative isolates that were tested on this medium, 16 of the specimens yielded B. pseudomallei. The isolation rate was found to be 1.5%. This medium was found to be simple and inexpensive, can be made by small laboratories, and called as Francis medium. Based on the colony morphology and color, a preliminary report can be made within 18-24 h for the presence of B. pseudomallei. Our study showed that this medium had an overall sensitivity of 78.4% with a specificity of 92.2%. The use of this medium as an early diagnostic tool will help to reduce mortality and morbidity of melioidosis patients.
    Matched MeSH terms: Melioidosis/diagnosis
  16. Chenthamarakshan V, Vadivelu J, Puthucheary SD
    Diagn Microbiol Infect Dis, 2001 Jan;39(1):1-7.
    PMID: 11173184
    IgM and IgG based ELISA systems were developed using the culture filtrate antigen (CFA) of Burkholderia pseudomallei. The assays were evaluated using 95 sera from 66 septicemic cases and 47 sera from 20 cases with localized melioidosis. In addition 65 sera from culture negative cases that were also serologically negative for other endemic infections clinically suspected of melioidosis were included. These were compared with sera from 260 non-melioidosis cases, 169 sera from individuals with high risk of acquiring the infection and 48 sera from healthy controls. The IgG-ELISA was 96% sensitive and 94% specific. All sera from cases with septicemic and localized infections and 61 of 63 sera from clinically suspected melioidosis cases were positive for IgG antibody. The geometric mean titre index (GMTI) values of IgG antibody in melioidosis cases were significantly higher (p < 0.0005) compared to that of healthy subjects, high risk group and subjects with non-melioidosis infections. The sensitivity and specificity of IgM ELISA was 74 and 99% respectively. The GMTI value of IgM antibody in the sera of melioidosis cases was significantly higher as compared to that of non-melioidosis disease controls (p < or = 0.001). These results demonstrate that the detection of IgG is a better indicator of the disease in the diagnosis of melioidosis.
    Matched MeSH terms: Melioidosis/diagnosis*
  17. Allwood EM, Logue CA, Hafner GJ, Ketheesan N, Norton RE, Peak IR, et al.
    FEMS Immunol. Med. Microbiol., 2008 Oct;54(1):144-53.
    PMID: 18657105 DOI: 10.1111/j.1574-695X.2008.00464.x
    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic to Southeast Asia and northern Australia. Clinical manifestations of the disease are diverse, ranging from chronic localized infection to acute septicaemia, with death occurring within 24-48 h after the onset of symptoms. Definitive diagnosis of melioidosis involves bacterial culture and identification, with results obtained within 3-4 days. This delayed diagnosis is a major contributing factor to high mortality rates. Rapid diagnosis is vital for successful management of the disease. This study describes the purification and evaluation of three recombinant antigenic proteins, BPSL0972, BipD and OmpA from B. pseudomallei 08, for their potential in the serodiagnosis of melioidosis using an indirect enzyme-linked immunosorbent assay (ELISA) method. The recombinant proteins were evaluated using 74 serum samples from culture-confirmed melioidosis patients from Malaysia, Thailand and Australia. In addition, 62 nonmelioidosis controls consisting of serum samples from clinically suspected melioidosis patients (n=20) and from healthy blood donors from an endemic region (n=18) and a nonendemic region (n=24) were included. The indirect ELISAs using BipD and BPSL0972 as antigens demonstrated poor to moderate sensitivities (42% and 51%, respectively) but good specificity (both 100%). In contrast, the indirect ELISA using OmpA as an antigen achieved 95% sensitivity and 98% specificity. These results highlight the potential for OmpA to be used in the serodiagnosis of melioidosis in an endemic area.
    Matched MeSH terms: Melioidosis/diagnosis*
  18. Tan RZ, Mohd Nor F, Shafie S, Tan LJ
    Forensic Sci Med Pathol, 2019 03;15(1):151-154.
    PMID: 30293222 DOI: 10.1007/s12024-018-0026-3
    Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a gram-negative intracellular bacillus. Tuberculosis, also an infectious disease, is caused by Mycobacterium tuberculosis, an acid fast bacillus. In both diseases, patients commonly present with fever and respiratory symptoms due to sepsis which might lead to respiratory failure or sudden death if left untreated. Not only are these two entities similar in clinical presentation, but the autopsy findings may mimic each other, giving rise to difficulties in determining the cause of death. We report a case of melioidosis and compare it to a typical case of miliary tuberculosis. Similarities between the cases on gross and histopathological examinations are discussed. In such circumstances, microbiological culture of bodily fluids and internal organs should be performed to ascertain the correct cause of death.
    Matched MeSH terms: Melioidosis/diagnosis*
  19. Mohan A, Manan K, Tan LS, Tan YC, Chin ST, Ahmad R, et al.
    Int J Infect Dis, 2020 Sep;98:59-66.
    PMID: 32535300 DOI: 10.1016/j.ijid.2020.06.025
    OBJECTIVES: Melioidosis is associated with extremely high case fatality ratios. The aim of this study was to determine whether detection of abdominal visceral abscesses can facilitate diagnosis of melioidosis in children.

    METHODS: We conducted a retrospective analysis of all children who had liver and/or spleen abscesses on abdominal ultrasonography admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2014 until December 2018.

    RESULTS: Fifty-three children had liver and/or spleen abscesses. Spleen abscesses were present in 48 (91%) cases; liver abscesses in 15 (28%). Melioidosis was confirmed by culture in 9 (17%) children; small occult splenic abscesses were present in all cases. In 78% of these cases, the lesions were detected before any positive culture (or serology) results were available. Four (8%) children had bacteriologically-confirmed tuberculosis. Two (4%) had Staphylococcus aureus infection. Of the remaining 38 (72%) culture-negative cases, 36 (95%) had clinical and imaging characteristics similar to that of children with culture-confirmed melioidosis and improved with empirical melioidosis antibiotic therapy.

    CONCLUSIONS: A large number of children in Bintulu Hospital in Sarawak, Malaysia, were found to have spleen abscesses. Melioidosis was the most common etiology identified in these children. Abdominal ultrasonography is extremely useful in facilitating the diagnosis of pediatric melioidosis.

    Matched MeSH terms: Melioidosis/diagnosis*
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