1/17. An indigenous melioidosis: a case report.melioidosis is a rare but potentially fatal infectious disease in taiwan, although it has been endemic in Southeast asia, especially northeast thailand, and northern australia. In this article, we report a male diabetes with fulminant pneumonia, and septicemia caused by burkholderia pseudomallei without traveling abroad before this episode. Productive cough and intermittent chills, high fever for one week, followed by progressively deteriorating dyspnea, shock, disturbed consciousness status were the major presentations. blood culture grew B. pseudomallei on the fifth admission day. Unfortunately, the patient died on the 9th admission day, despite intensive care and the broad-spectrum antimicrobial regimen used.- - - - - - - - - - ranking = 1keywords = diabetes (Clic here for more details about this article) |
2/17. imipenem for the treatment of melioidosis.melioidosis is a protean disease caused by burkholderia pseudomallei. It is rare in the UK and is generally only seen in patients with a travel history to endemic areas such as thailand, singapore and malaysia. Cases may present with disseminated bacteraemic, non-disseminated bacteraemic, multi-focal bacteraemic or localized disease. Subclinical infections also occur. Following acquisition of the organism a patient may remain asymptomatic for several years before infection becomes clinically apparent. Factors such as diabetes, renal failure or other causes for a decrease in host immunity may precipitate the appearance of overt disease. The current treatment choice for severe melioidosis is parenteral ceftazidime followed by oral amoxycillin-clavulanic acid or a combination of co-trimoxazole, doxycycline and chloramphenicol. We report a case of melioidosis in a 59-year-old male diabetic from bangladesh who initially responded to piperacillin-tazobactam but was changed to ceftazidime when a definitive diagnosis was made. His condition deteriorated on the latter antibiotic. He subsequently responded to imipenem. The patient's long-term outcome is still not known.- - - - - - - - - - ranking = 1keywords = diabetes (Clic here for more details about this article) |
3/17. melioidosis, an environmental and occupational hazard in thailand.melioidosis is a tropical environmental hazard that causes acute and chronic pulmonary disease, abscesses of the skin and internal organs, meningitis, brain abscess and cerebritis, and acute fulminant rapidly fatal sepsis. It is more common among adults, individuals with diabetes, and individuals with chronic renal disease, but it can occur in normal hosts and children. Burkholderia pseudomellei is the most prevalent cause of community-acquired pneumonia, liver and splenic abscess, and sepsis in northeastern thailand. melioidosis can reactivate years after primary infection and result in chronic or acute life-threatening disease. With increasing worldwide travel and migration, patients may present in nonendemic countries with reactivation melioidosis decades after leaving an endemic region. We discuss seven selected patients presenting with this disease to a tertiary care facility in Bangkok between 1995 and 1997. awareness should allow early diagnosis and treatment, which can lead to decreased morbidity and mortality.- - - - - - - - - - ranking = 1keywords = diabetes (Clic here for more details about this article) |
4/17. imipenem therapy for septicemic melioidosis in a child with penicillin and cephalosporin adverse reaction.The recommended treatment for severe melioidosis is ceftazidime or a combination of ceftazidime and trimethoprim-sulfamethoxazole (TMP/SMX). amoxicillin-clavulanate has been shown to be an effective alternative therapy. In patient who is allergic to penicillin and cephalosporin, imipenem an alternative drug may be used. We described a 10 year-old boy who was diagnosed as septicemic melioidosis and type 1 diabetes mellitus. He developed fever and rash while being given ceftazidime and TMP/SMX. The fever recurred when amoxicillin-clavulanate was administered orally. He was successfully treated with imipenem.- - - - - - - - - - ranking = 7.0017630874956keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
5/17. melioidosis and Pandora's box in the Lao People's Democratic Republic.melioidosis has not been recognized previously in laos, but within months of starting a prospective study of community acquired septicemia in Vientiane, 2 patients with melioidosis were identified. One was a previously healthy, 44-year-old female rice farmer who presented with supraclavicular lymphadenitis and the other was a 74-year-old man with diabetes and renal calculi who was receiving corticosteroids and had septicemia and septic arthritis.- - - - - - - - - - ranking = 1keywords = diabetes (Clic here for more details about this article) |
6/17. Fulminant septic melioidosis after a vacation in thailand.Severe infection with burkholderia pseudomallei (formerly pseudomonas pseudomallei), the bacterium causing melioidosis, is a common cause of acquired septicaemia in south-east asia and northern australia. A few cases of infected travellers returning to European countries have been reported. melioidosis is a tropical disease, the clinical presentation ranging from asymptomatic infection to fulminant sepsis. Predisposing conditions such as impaired cellular immunity, preexisting renal failure or diabetes mellitus seem to enhance the severity of the disease. For a definite diagnosis the bacterium has to be isolated. The antimicrobial treatment of choice is ceftazidime in combination with co-trimoxazole or doxycycline. Even with correct antibiotic treatment the mortality rate is high in cases of fulminant sepsis. We report a 29-year old man with Type I diabetes who acquired melioidosis during a vacation in thailand. After returning to austria he was admitted to the intensive care unit with multiple organ failure. Despite intensive care treatment the patient's infection proved lethal. burkholderia pseudomallei was isolated from the blood and bronchoalveolar lavage.- - - - - - - - - - ranking = 8.0017630874956keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
7/17. Acute respiratory failure in melioidosis.BACKGROUND: In melioidosis caused by burkholderia pseudomallei, although every organ in the body may be involved, the highest mortality of 73% occurs when the respiratory system is affected. These patients invariably die of acute respiratory failure. Most of them also have underlying predisposing factors like diabetes mellitus. AIM OF STUDY: A retrospective study of six such cases was carried out in order to elicit the possible causes and mechanisms of acute respiratory failure in patients with melioidosis. METHOD: patients' records were reviewed for demographic, clinical, laboratory, radiological and histopathological data. RESULTS: The rapidity of onset of respiratory failure was remarkable and was accompanied by relentless hypoxaemia that was refractory to treatment despite the application of high positive end expiratory pressure and other supportive measures. All had bilateral opacities on frontal chest radiographs, focal and diffuse necrotizing pneumonia and presence of hyaline membranes in lung tissues seen histologically, supporting the accepted criteria for ALI/ARDS. CONCLUSION: patients with sepsis due to B. pseudomallei develop ALI/ARDS very rapidly resulting in high mortality rates. Possible mechanisms involved are discussed.awareness of the disease in endemic areas, the development of rapid diagnostic methods and appropriate management procedures are urgently needed for the prevention of ARDS and subsequent reduction in mortality in such cases.- - - - - - - - - - ranking = 7.0017630874956keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
8/17. melioidosis in a traveller from thailand: case report.A 42-year old Italian male with type 2 diabetes and HCV-related chronic hepatitis spent 6 months in thailand. After his return in June 2002 he was admitted to the Infectious Diseases Unit of the Hospital of Livorno (italy) because of fever, chest pain and skin abscesses in the legs. Chest x-rays and CT scan revealed multiple bilateral cavitary lesions in the lungs. ultrasonography and CT scan showed numerous subcentimetric spleen abscesses. burkholderia pseudomallei was isolated from the cutaneous lesions and sputum and thus melioidosis was diagnosed. A 6-week course of i.v. ceftazidime plus oral doxycycline was given during the acute phase of the illness. The in vitro susceptibility testing showed that long-term (20 weeks) antimicrobial therapy with doxycycline and moxifloxacin was required. Complete resolution of pulmonary and spleen lesions was obtained within 6 weeks of therapy and of cutaneous abscesses in 10 weeks. No significant side effects were noted during the follow-up period using this scheme of antimicrobial therapy.- - - - - - - - - - ranking = 1keywords = diabetes (Clic here for more details about this article) |
9/17. Severe community-acquired pneumonia and sepsis caused by burkholderia pseudomallei associated with flooding in puerto rico.burkholderia pseudomallei (melioidosis) is usually found in endemic areas of Southeast asia and Northern australia. However, a few cases of confirmed melioidosis indigenous to puerto rico and the americas have been reported previously. We describe the occurrence of a B. pseudomallei infection in a female with insulin-dependent diabetes mellitus exposed to flood waters in puerto rico. We conclude that B. pseudomallei should be considered a potential pathogen in high-risk patients with severe community-acquired pneumonia and sepsis in Puerto Rico especially in individuals exposed to flood waters during rainy seasons. A more thorough epidemiologic and microbiologic surveillance with environmental sampling may be warranted in the island.- - - - - - - - - - ranking = 7.0017630874956keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
10/17. Pulmonary melioidosis presenting with right paratracheal mass.A rare case of pulmonary melioidosis is reported. The patient was a 62-year-old man presenting with subacute fever, dry cough, and significant weight loss. A chest x-ray revealed a right paratracheal mass. The findings from fiberoptic bronchoscopy were a blunt carina and normal tracheobronchial tree. The patient had an underlying disease of poorly controlled diabetes mellitus, heavy smoking, and heavy alcoholic drinking. One of the two cultured blood specimens grew B. pseudomallei. The pathological finding of transbronchial biopsy at the apical segment of the right upper lung showed lymphocytic infiltrates. He was treated with two weeks of intravenous ceftazidime plus cotrimoxazole followed by 5 months of oral doxycycline plus cotrimoxazole. Clinical symptoms significantly improved and the right paratracheal mass disappeared.- - - - - - - - - - ranking = 7.0017630874956keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
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