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Fulltext Burkholderia Pseudomallei As The Predominant Cause Of Splenic Abscess In Kapit, Sarawak, Malaysian Borneo

Chang CY

J Ayub Med Coll Abbottabad, 2023;35(2):348-350.
PMID: 37422837 DOI: 10.55519/JAMC-02-11390

BACKGROUND: Splenic abscess is an uncommon condition, with autopsy studies estimating an incidence rate of 0.14-0.70%. Causative organisms can be extremely diverse. Burkholderia pseudomallei is the most common cause of splenic abscess in melioidosis-endemic areas.
METHODS: We reviewed 39 cases of splenic abscesses in a district hospital in Kapit, Sarawak, from January 2017 to December 2018. The demographics, clinical characteristics, underlying diseases, causative organisms, therapeutic methods, and mortality rates were investigated.
RESULTS: There were 21 males and 18 females (mean age, 33.7±2.7 years). Almost all patients (97.4%) had a history of pyrexia. Diabetes mellitus was present in 8 patients (20.5%). Splenic abscesses were diagnosed using ultrasonography and were multiple in all 39 cases. Positive blood cultures were obtained in 20 patients (51.3%), and all yielded B. pseudomallei. Melioidosis serology was positive in 9 of 19 patients (47.4%) with negative blood cultures. All patients were treated for melioidosis with antibiotics without the need for surgical intervention. All splenic abscesses resolved after anti-melioidosis treatment was completed. One patient died (2.6%) as a result of B. pseudomallei septicaemia with multiorgan failure.
CONCLUSIONS: Ultrasonography is a valuable tool for diagnosing splenic abscesses in resource-limited settings. B. pseudomallei was the most common etiological agent of splenic abscesses in our study.

Matched MeSH terms: Abscess/complications
Fulltext A Fatal Case Of Persistent Burkholderia Pseudomallei Bacteraemia With Severe Pneumonia And Splenic Abscess

Chang CY, Lee HL

J Ayub Med Coll Abbottabad, 2023;35(2):331-333.
PMID: 37422833 DOI: 10.55519/JAMC-02-11131

Burkholderia pseudomallei is a Gram-negative bacterium that causes melioidosis. Melioidosis is a potentially fatal disease that is endemic in Southeast Asia and Northern Australia and is being increasingly recognized in other regions worldwide. Melioidosis can affect any organ system and present with a wide range of clinical manifestations including pneumonia, bone, skin/soft tissue, or central nervous system infections. In this report, we describe a diabetic farmer who succumbed to persistent B. pseudomallei bacteraemia with multiorgan involvement despite treatment with meropenem and ceftazidime.

Matched MeSH terms: Abscess/complications
Fulltext Life-threatening parapharyngeal and retropharyngeal abscess in an infant

Balasubramanian A, Shah JR, Gazali N, Rajan P

BMJ Case Rep, 2017 Oct 09;2017.
PMID: 28993356 DOI: 10.1136/bcr-2017-221269

Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5.3×8 cm collection involving the left parapharyngeal and retropharyngeal space, causing significant airway narrowing. 40 mL of frank pus was drained via intraoral incision and drainage with the aid of endoscope, and undesirable complications from an external approach were averted. The infant was extubated 48 hours postsurgery and was discharged home well after completion of 1 week of intravenous antibiotics. The child was discharged well from our follow-up at 1 month review. We discuss the pathophysiology of deep neck space abscesses, its incidence in the paediatric population and the various management options.

Matched MeSH terms: Retropharyngeal Abscess/complications
Fulltext The management of psoas abscess

Bajaj HN, Choong LT

Med J Malaysia, 1998 Sep;53 Suppl A:95-8.
PMID: 10968189

The presentation and management of psoas abscess was studied prospectively in 5 patients and retrospectively in 4. 3 patients had bilateral abscesses. All patients had back pain and a mass in loin or iliac fossa. 7 patients had no hip findings. One patient had a perinephric abscess and another had radiological features of tuberculosis of the spine. In the other seven no cause for the abscess could be identified. Ultrasonography demonstrated the abscess in all patients; CT scanning done in 5 patients was confirmatory. Drainage was done by an extraperitoneal route. Biopsy of the abscess wall in 2 patients demonstrated tuberculosis. They, the patient with TB spine and 3 others put empirically on anti-tuberculosis chemotherapy responded well. The perinephric abscess grew Pseudomonas sensitive to gentamycin, but she and two other patients died due to multiorgan failure.

Matched MeSH terms: Abscess/complications; Psoas Abscess/complications