MyMedR

Fulltext Melioidosis in Pahang, Malaysia

How SH, Ng KH, Jamalludin AR, Shah A, Rathor Y

Med J Malaysia, 2005 Dec;60(5):606-13.

We conducted a retrospective review of 135 patients with melioidosis in Pahang from January 2000 to June 2003. Patients were mostly male (78.5%) and Malay (83%) with a median age of 51 years. Seventy four percent of patients were diabetic. Common presentations were pneumonia (40.7%), septicaemic without obvious source of infection (19.3%) and multiple organ involvement (15.6%). Only 32.7% were given appropriate antibiotics empirically. The overall mortality was 54% with most deaths (65%) occurring within 48 hours of admission. Patients with pneumonia, multiple organ involvement and septicaemic of unknown source had higher mortality as compared to patients with subcutaneous, musculoskeletal or single internal organ involvement without pneumonia (p < 0.001). The relapse rate was 19.2%.

Matched MeSH terms: Melioidosis/etiology; Melioidosis/epidemiology*; Melioidosis/therapy

Fulltext Melioidosis: the Johor Bahru experience

Pagalavan L

Med J Malaysia, 2005 Dec;60(5):599-605.

PMID: 16515111

A 5 year retrospective review of cases of melioidosis was carried out in Sultanah Aminah Hospital, Johor Bahru. There were 44 new cases of melioidosis which was proven by either blood or pus culture growing Burkholderia pseudomallei from the period between January 1999 and December 2003. Of these, 38 (86.4%) were males compared to only 6 (13.6%) females. Thirty-one (70.5%) were Malays, 7 (15.9%) were Chinese, 5 (11.4%) were Indians and 1 (2.2%) was a Sarawakian. The peak age group was between 50 and 59 years (31.8%). Out of these 44 new cases, only 32 medical records could be retrieved and analysed. Twenty-four out of 32 patients (75%) analysed had diabetes mellitus, 4 had chronic or end stage renal failure (CRF/ESRF) and only 1 had Human Immunodeficiency Virus (HIV). One case of "near drowning" was also recorded. Twenty-one out of 44 patients or 47.7% died, of which 8 (38.1%) died within 24 hours of admission. Pulmonary involvement was recorded in 62.6% of the patients but many had signs and symptoms of multiorgan involvement.

Matched MeSH terms: Melioidosis/ethnology; Melioidosis/epidemiology*

Fulltext Melioidosis--should it be a notifiable disease in Malaysia?

Jayaram M

Med J Malaysia, 2005 Dec;60(5):531-4.

PMID: 16515101

Matched MeSH terms: Melioidosis/epidemiology*

Fulltext Antimicrobial prophylaxis for melioidosis and leptospirosis for at risk rescue workers

Yew KL

Med J Malaysia, 2013;68(1):88.

PMID: 23466779

Matched MeSH terms: Melioidosis*

Fulltext Neonatal meliodosis: very rare but be aware

Ang YM

Med J Malaysia, 2005 Mar;60(1):99-102.

PMID: 16250291 MyJurnal

Meliodosis is an infectious disease encountered mainly in tropics. It is not an uncommon problem in Malaysia especially in areas with agricultural activities. Although it can occur in all age groups, there have been few reported cases in children. Men are more commonly affected than women due to outdoor activities. Neonatal cases have been reported in Hawaii and Thailand. These infants presented with neonatal sepsis or meningitis. The mode of transmission to these infants has not been elucidated. This is the report of such a case first reported in Hospital Tengku Ampun Afzan, Kuantan.

Matched MeSH terms: Melioidosis/diagnosis*; Melioidosis/therapy*

Fulltext Urogenital melioidosis: a review of clinical presentations, characteristic and outcomes

Chong Vh VH, Sharif F, Bickle I

Med J Malaysia, 2014 Dec;69(6):257-60.

PMID: 25934955 MyJurnal

INTRODUCTION: Melioidosis is endemic to the tropical regions, in particular Thailand and Northern Australia. Any organ can be affected by melioidosis. Involvement of the urogenital system is common in Northern Australia, but is less common in other regions. This study assesses the characteristics of melioidosis affecting the urogenital system treated in a tertiary referral centre in Brunei Darussalam.

MATERIAL AND METHODS: All patients treated for melioidosis of the urogenital system were identified and retrospectively reviewed.

RESULTS: There were 9 patients with 11 episodes of urogenital infections treated over 13 years. The median age at diagnosis was 38 years old (range 29 - 63) with men predominantly affected. The major risk factor was underlying diabetes mellitus (n=9), including three patients diagnosed at the time of diagnosis of melioidosis. The median glycosylated haemoglobin (HbA1c) was 12.8% (range 6.4 to 16.6%). One patient's risk factor was only moderate alcohol consumption. Common symptoms included; fever, lethargy, rigor and anorexia. Dysuria was reported by two patients. The median duration of symptoms before presentation was 7 days (range 2 to 21 days) and the median number of sites involved were 3 (range of 2 to 6). Urogenital involvement included prostate (n=6), kidney (n=8), seminal vesicles (n=1) and testis (n=1). Radiological imaging showed that large prostate abscesses (>4.5cm) were common, and in some patients, the kidney abscess had the 'honeycomb' previously described as typical for melioidosis liver abscess. All patients were successfully treated for melioidosis and at a median follow up of 34 months (range 1 - 97), there was one death from complications of diabetes mellitus.

CONCLUSION: Urogenital melioidosis only accounted for a small proportion of all melioidosis involvement, with prostate and kidney most commonly affected. Concomitant involvement of other sites were common. The major risk factor was poorly controlled diabetes mellitus.

Matched MeSH terms: Melioidosis

Fulltext Melioidosis of the head and neck

Lim WK, Gurdeep GS, Norain K

Med J Malaysia, 2001 Dec;56(4):471-7.

PMID: 12014768

Melioidosis is a potentially deadly infection that can affect any organ system. Reports of melioidosis of the ENT/head and neck region are relatively uncommon. Four cases are presented: (i) parotid abscess evolving into necrotising fasciitis, (ii) acute sinusitis and parapharyngeal cellulitis resulting in upper airway obstruction, (iii) acute suppurative lymphadenitis (iv) and chronic suppurative otitis media causing meningoencephalitis. Three of the four cases are believed to be unique, as a literature review of melioidosis in ENT/head and neck is also presented. Some practical issues of management are also discussed. Not suspecting melioidosis does not change contemporary empirical broadspectrum antibiotic therapy. The value of suspicion or on confirmation of diagnosis lies in anticipating and planning for rapid change.

Matched MeSH terms: Melioidosis/diagnosis*

Fulltext Septicaemic pulmonary melioidosis with cutaneous pustules

Liam CK

Med J Malaysia, 1993 Jun;48(2):248-9.

PMID: 8350807

Matched MeSH terms: Melioidosis/complications*

Disseminated Melioidosis with Spinal Intraosseous Abscess

Soo KC, Lee KS, Ooi SY, Darwina A, Sannasey S, Lee HG

Med J Malaysia, 2021 03;76(2):251-253.

PMID: 33742639

Melioidosis is endemic in the State of Sabah, Malaysia. We report a case of a 34-year-old man with one-week history of fever and cough, three days history of diarrhoea and vomiting, which was associated with a loss of appetite and loss of weight for one-month. Clinically, he had hepatosplenomegaly and crepitation over his right lower zone of lung. Chest radiograph showed right lower lobe consolidation. Ultrasound abdomen showed liver and splenic abscesses. Ultrasound guided drainage of splenic abscess yielded Burkholderia pseudomallei. Magnetic resonance imaging (MRI) lumbosacral confirmed right sacral intraosseous abscess after he developed back pain a week later. He received 6 weeks of intravenous antibiotics and oral co-trimoxazole, followed by 6 months oral co-trimoxazole and had full recovery.

Matched MeSH terms: Melioidosis

Fulltext Concurrent Influenza A and Pulmonary Melioidosis in pregnancy

Tan WF, Lee HG

Med J Malaysia, 2021 03;76(2):245-247.

PMID: 33742637

Melioidosis is endemic in Sabah. It causes significant morbidity and mortality if diagnosis and treatment is delayed. Important risk factors include diabetes, chronic kidney diseases, chronic lung diseases, thalassaemia, immunosuppressive therapy, and hazardous alcohol consumption. Influenza A is usually a self-limiting disease but is associated with high morbidity and mortality in highrisk populations especially during pregnancy. Both melioidosis and influenza A commonly present in patients with pneumonia. Secondary bacterial pneumonia is a known complication in approximately one third of patients with severe pneumonia due to influenza A, resulting in intensive care unit admissions. However, melioidosis is not commonly recognized as an aetiology in secondary bacterial pneumonia complicating influenza A infection. This is important as empirical antibiotics that are used to treat secondary bacterial pneumonia due to influenza A often do not cover melioidosis. Here we report a rare case of concurrent pulmonary melioidosis and influenza A in a 30- year-old primigravida at 27 weeks of pregnancy in the Queen Elizabeth Hospital, Sabah, Malaysia to highlight the challenge in the recognition and management of both infections in a melioidosis endemic area.

Matched MeSH terms: Melioidosis

Melioidosis: a report of two cases

Tian Seng N

Med J Malaysia, 1979 Mar;33(3):269-71.

PMID: 522734

Matched MeSH terms: Melioidosis*

A 5-year retrospective study of melioidosis cases treated in a district specialist hospital

Tang RY, Lim SH, Lam JE, Nurasykin S, Eileen T, Chan YW

Med J Malaysia, 2019 12;74(6):472-476.

PMID: 31929471

INTRODUCTION: Melioidosis is caused by Burkholderia pseudomallei, a gram-negative aerobic bacillus, found in the soil and surface water. Treating melioidosis has been a challenge in district hospitals due to high usage of broad spectrum antibiotics and prolonged hospitalisation. This study is to review the patients' demography, clinical presentations and microbiological data.

METHODS: A 5-year retrospective study was carried out on patients admitted with culture positive for melioidosis from year 2013 to 2017 in Hospital Teluk Intan, Perak.

RESULTS: There were a total of 46 confirmed cases of melioidosis. Majority of the patients were working in the agricultural and farming (28.6%), and factories (25.7%). Thirty-one patients had diabetes mellitus (71.1%). Presentations of patients with melioidosis included pneumonia (54.3%), skin and soft tissue infection (19.6%), deep abscesses (15.2%) and bone and joint infections (13%). An average of 5.8 days was needed to confirm the diagnosis of melioidosis via positive culture. However, only 39.4% of these patients were started on ceftazidime or carbapenem as the empirical therapy. The intensive care unit (ICU) admission rate for melioidosis was 46% and the mortality rate was 52%. Our microbial cultures showed good sensitivity towards cotrimoxazole (97.1%), ceftazidime (100%) and carbapenem (100%).

CONCLUSION: Melioidosis carries high mortality rate, especially with lung involvement and bacteremia. Physicians should have high clinical suspicion for melioidosis cases to give appropriate antimelioidosis therapy early.

Matched MeSH terms: Melioidosis/drug therapy*; Melioidosis/microbiology; Melioidosis/epidemiology

A case of chronic melioidosis responding to tetracycline therapy

Jegathesan M, Chye GH, Chik T, Singh RB

Med J Malaya, 1972 Dec;27(2):150-2.

PMID: 4268042

Matched MeSH terms: Melioidosis/drug therapy*

Melioidosis in Malaysia. IV. Intensive ecological study of Carey Island, Selangor, for Pseudomonas pseudomallei

Strauss JM, Ellison DW, Gan E, Jason S, Marcarelli JL, Rapmund G

Med J Malaya, 1969 Dec;24(2):94-100.

PMID: 4244150

Matched MeSH terms: Melioidosis/epidemiology*

Chronic melioidosis

Smith KV, Grimmond T, Monk I

Med J Aust, 1975 Sep 20;2(12):479-80.

PMID: 1196186

This report is of a man who suffered from chronic melioidosis contracted in Malaysia. In the course of the disease he had a lobe of a lung resected, developed empyema and, while this was still draining, developed infection in an ankle. Both the empyema thoracis and the ankle infection were due to Pseudomonas pseudomallel. He now appears to be cured, probably by massive doses of tetracycline.

Matched MeSH terms: Melioidosis*

An unusual neurological complication from a garden-variety organism: post-melioidosis parkinsonism

Ng CS, Azmin S, Law ZK, Sahathevan R, Wan Yahya WN, Remli R, et al.

Med J Aust, 2015 Apr 06;202(6):333-4.

PMID: 25832163

Matched MeSH terms: Melioidosis/complications*; Melioidosis/drug therapy*

Fulltext A mimicry of melioidosis by Klebsiella ozaenae infection

Ng TH, How SH, Kuan YC, Adzura, Aziz AA, Fauzi AR

Malays J Pathol, 2009 Dec;31(2):147-50.

PMID: 20514860 MyJurnal

Klebsiella ozaenae is a Gram negative bacillus. It has been described as a colonizer of oral and nasopharyngeal mucosa and is a cause of atrophic rhinitis. Klebsiella ozaenae has seldom been isolated from serious infections. However, several reports have stated that Klebsiella ozaenae may cause invasive infections and even mortality. We report a 55-year-old man with Klebsiella ozaenae infection causing abscesses involving the right eye and left kidney and possibly also in the brain, lungs and prostate. The isolates were sensitive to ceftazidime, ciprofloxacin, chloramphenicol, gentamicin and sulfamethoxazole-trimethoprim but resistant to ampicillin. He responded well to 4 weeks of i.v. ceftazidime and i.v. amoxycillin-clavulanic acid. To our knowledge, such a multiorgan infection has not been reported previously for this organism.

Matched MeSH terms: Melioidosis/diagnosis*

An electronmicroscopic study of the interaction of Burkholderia pseudomallei and human macrophages

Nathan SA, Puthucheary SD

Malays J Pathol, 2005 Jun;27(1):3-7.

PMID: 16676686

B. pseudomallei has been shown to persist intracellularly in melioidosis patients until reactivated by decreasing immunocompetence. We have shown by transmission electron microscopy the internalization of B. pseudomallei by human macrophages via conventional phagocytosis enclosed within membrane-bound vacuoles or phagosomes. Ferritin labeled lysosomes provided evidence of phagosome-lysosome fusion. Ingested bacilli were designated as "intact" or "damaged" on the basis of their ultrastructural features. An intact bacterium was seen with low electron opaque central nuclear region surrounded by dense bacterial cytoplasm, bounded externally by bacterial plasma membrane and cell wall. In contrast, B. pseudomallei were considered damaged when seen with cavitation within the central nuclear region, separation of bacterial cytoplasm from the cell wall, herniation of cytoplasmic contents and lamination of bacterial cell wall and its surrounding electron transparent zone. Our observations indicate that the microbicidal mechanism(s) in B. pseudomallei-infected macrophages failed to ensure complete clearance of the organism and this failure probably facilitates intracellular persistence and proliferation, and this may be one of the survival strategies adopted by this organism.

Matched MeSH terms: Melioidosis/immunology

Parapharyngeal space melioidosis in a diabetic

Elango S, Sivakumaran S

J Laryngol Otol, 1991 Jul;105(7):582-3.

PMID: 1875146

Pseudomonas pseudomallei, a gram negative organism causing melioidosis, is found in tropical and subtropical regions. It may manifest as a pulmonary lesion, osteomyelitis, soft tissue abscesses, abscesses in various organs or in septicaemic form. Melioidosis of the parapharyngeal space has not been reported so far. A case of melioidosis of the parapharyngeal space which was successfully treated by drainage and prolonged antibiotic therapy is reported here. Melioidosis should be suspected in severe forms of deep neck space infection, especially if the patient comes from an endemic area.

Matched MeSH terms: Melioidosis/complications*; Melioidosis/therapy

Fulltext Functional characterizations of effector protein BipC, a type III secretion system protein, in Burkholderia pseudomallei pathogenesis

Kang WT, Vellasamy KM, Chua EG, Vadivelu J

J Infect Dis, 2015 Mar 1;211(5):827-34.

PMID: 25165162 DOI: 10.1093/infdis/jiu492

OBJECTIVES: The bsa locus of Burkholderia pseudomallei encodes several proteins that are components of the type III secretion system (TTSS). BipC was postulated as one of the TTSS-3 effector proteins, but its role in the pathogenesis of B. pseudomallei infection is not well understood. Thus, the aim of this study was to determine its role(s) in the virulence of B. pseudomallei pathogenesis.
METHODS: A bipC TTSS-3-deficient strain of B. pseudomallei and complemented strains were generated to assess the role of BipC as a type III translocation apparatus. Human cell lines and a mouse model of melioidosis were used for in vitro and in vivo assays, respectively.
RESULTS: A significant 2-fold reduction was demonstrated in the percentage of adherence, invasion, intracellular survival, and phagosomal escape of the bipC mutant. Interestingly, microscopic studies have shown that BipC was capable of delayed B. pseudomallei actin-based motility. The virulence of the mutant strain in a murine model of melioidosis demonstrated that the bipC mutant was less virulent, compared with the wild type.
CONCLUSION: The results suggested that BipC possesses virulence determinants that play significant roles in host cell invasion and immune evasion.
KEYWORDS: BipC; Burkholderia pseudomallei; host cell invasion; type III secretion system; type III translocation apparatus; virulence

Matched MeSH terms: Melioidosis/microbiology; Melioidosis/pathology

Displaying publications 41 - 60 of 226 in total