Case Series of Burkholderia Pseudomallei Infections in Critically Ill Patients: Unveiling Key Challenges
Abstract
Melioidosis remains a diagnostic challenge in tropical regions due to its broad clinical spectrum. This series presents seven diabetic individuals from an endemic area with diverse forms of the disease, including pulmonary, visceral, soft tissue and lymph node involvement. Laboratory confirmation was achieved through culture and nested polymerase chain reaction (PCR). Most patients improved with appropriate intravenous therapy followed by oral antibiotics; one experienced recurrence. The varied presentations often resemble other endemic infections, delaying diagnosis. Prompt clinical recognition and early use of molecular tools are vital for initiating targeted treatment and improving outcomes in vulnerable populations.
References
Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev. 2005 Apr;18(2):383-416. doi:10.1128/CMR.18.2.383-416.2005.
Currie BJ. Melioidosis: evolving concepts in epidemiology, pathogenesis, and treatment. Semin Respir Crit Care Med. 2015 Feb;36(1):111-25. doi:10.1055/s-0034-1398389.
Saravu K, Mukhopadhyay C, Vishwanath S, Valsalan R, Docherla M, Vandana KE, et al. Melioidosis in southern India: epidemiological and clinical profile. Southeast Asian J Trop Med Public Health. 2010 Mar;41(2):401-9. PMID:20578524.
Vidyalakshmi K, Shrikala B, Bharathi B, Suchitra U. Melioidosis: an under-diagnosed entity in western coastal India: a clinico-microbiological analysis. Indian J Med Microbiol. 2007 Jul;25(3):245-8. doi:10.4103/0255-0857.34767.
Dance DAB. Melioidosis as an emerging global problem. Acta Trop. 2000 Jul 3;
(2-3):115-9. doi:10.1016/S0001-706X(99)00061-9.
Wiersinga WJ, Virk HS, Torres AG, Currie BJ, Peacock SJ, Dance DAB, et al. Melioidosis. Nat Rev Dis Primers. 2018 Feb 1;4:17107. doi:10.1038/nrdp.2017.107.
Wuthiekanun V, Desakorn V, Wongsuvan G, Amornchai P, Cheng AC, Maharjan B, et al. Rapid immunofluorescence microscopy for diagnosis of melioidosis. Clin Diagn Lab Immunol. 2005 Apr;12(4):555-6. doi:10.1128/CDLI.12.4.555-556.2005.
Merritt A, Inglis TJ, Chidlow G, Harnett G. PCR-based identification of Burkholderia pseudomallei. Rev Inst Med Trop Sao Paulo. 2006 Sep-Oct;48(5):239-44. doi:10.1590/s0036-46652006000500001.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).