MyMedR

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*

In-vitro susceptibility of Pseudomonas pseudomallei isolated in Malaysia to some new cephalosporins and a quinolone

Cheong YM, Joseph PG, Koay AS

Southeast Asian J Trop Med Public Health, 1987 Mar;18(1):94-6.

PMID: 3477872

The current drugs recommended for treatment of melioidosis are tetracycline, chloramphenicol and cotrimoxazole. Unfortunately these drugs are not the drug of choice in an acutely ill patient with septicaemia prior to the availability of laboratory results. With the discovery of the new cephalosporins which have a broad spectrum of activity clinicians are using them either alone or in combination with other antibiotics in such critical situations. Hence, an in-vitro study was carried out on the susceptibility of 41 strains of P. pseudomallei isolated in Malaysia, to these new cephalosporins and a new quinolone. The results showed that all the cephalosporins tested had some activity on the strains tested, with ceftazidime being the most active drug. Pefloxacin had very poor activity. However, further clinical studies are required to determine the duration, dosage and in-vivo activity of the antibiotics.

Matched MeSH terms: Melioidosis/drug therapy

Melioidosis imported into Nepal

Shrestha N, Sharma S, Khanal B, Bhatta N, Dhakal S

Scand. J. Infect. Dis., 2005;37(1):64-6.

PMID: 15764193

This is a report of the first recognized case of melioidosis in Nepal. Illness began 1 month after returning from Malaysia after a 1 y stay. The case highlights the importance of ascertaining the travel history in any patient with a suspected infectious disease in this age of global travel.

Matched MeSH terms: Melioidosis/drug therapy

Melioidosis pneumonia and blast injury

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/drug therapy

Septicaemic melioidosis: a review of 50 cases from Malaysia

Puthucheary SD, Parasakthi N, Lee MK

Trans R Soc Trop Med Hyg, 1992 11 1;86(6):683-5.

PMID: 1287945

Fifty cases of septicaemic melioidosis were reviewed. There was a preponderance of disease among males (male:female ratio 3.2:1) and those aged over 30 years. The presenting clinical features were very varied and not pathognomonic, ranging from fever, cough and septicaemia to fulminant septicaemia and shock. Pulmonary involvement was recorded in 58% of the patients. Skin and soft tissue sepsis was seen in 24%, but many had signs and symptoms of multiorgan involvement. Associated underlying illness was identified in 76% of patients, diabetes mellitus being the commonest (38%), while 34% had more than one predisposing factor. The mortality of 65% in our series is a reflection of the less than satisfactory status of the diagnosis and therapy of septicaemic melioidosis. Only 24% of our patients received appropriate empirical antibiotic therapy. A high index of suspicion of melioidosis in endemic areas and the use of appropriate empirical antimicrobial therapy would be a step towards reducing the high mortality rate.

Matched MeSH terms: Melioidosis/drug therapy

Imported melioidosis in a British native

Jenkins DR, Lewis AM, Strachan CJ

J Infect, 1990 Sep;21(2):221-2.

PMID: 2230183

Matched MeSH terms: Melioidosis/drug therapy

Acute septicaemic melioidosis: a report of seven cases

Puthucheary SD, Lin HP, Yap PK

Trop Geogr Med, 1981 Mar;33(1):19-22.

PMID: 7245336

A report is presented of seven patients with acute septicaemic melioidosis seen at the University Hospital, Kuala Lumpur, Malaysia, during 1976-1979. All had associated disorders which rendered them more susceptible to infection. As prognosis depends on early diagnosis it is important that this disease be considered in the differential diagnosis of a septicaemic illness in such patients from endemic areas. The treatment of choice is a combination of tetracyclines and chloramphenicol, initially used in massive doses, and continued for at least six month to prevent relapses.

Matched MeSH terms: Melioidosis/drug therapy

Imipenem for the treatment of melioidosis

Minassian MA, Gage A, Price E, Sefton AM

Int J Antimicrob Agents, 1999 Aug;12(3):263-5.

PMID: 10461846

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.

Matched MeSH terms: Melioidosis/drug therapy*

Potential of repurposing chloroquine as an adjunct therapy for melioidosis based on a murine model of Burkholderia pseudomallei infection

Ganesan N, Embi N, Hasidah MS

Trop Biomed, 2020 Jun 01;37(2):303-317.

PMID: 33612800

Burkholderia pseudomallei is the etiologic agent of melioidosis, a major cause of community-acquired pneumonia and sepsis in the endemic areas. The overall mortality of patients with severe melioidosis remains high due to severe sepsis attributed to overwhelming inflammatory cytokine response in spite of recommended antibiotic therapy. It is crucial that therapeutic approaches beyond just effective antibiotic treatment such as adjunct therapy be considered to mitigate the dysregulated inflammatory signaling and augment host defenses. In an acute B. pseudomallei infection model, we have previously demonstrated that treatment with anti-malarial drug, chloroquine, modulated inflammatory cytokine levels and increased animal survivability via Akt-mediated inhibition of glycogen synthase kinase-3β (GSK3β). GSK3β is a downstream effector molecule within the phosphatidylinositol 3-kinase (PI3K)/ Akt axis which plays a pivotal role in regulating the production of pro- and anti-inflammatory cytokines. Here we evaluate the effect of chloroquine treatment in combination with a subtherapeutic dose of the antibiotic doxycycline on animal survivability, cytokine levels and phosphorylation states of GSK3β (Ser9) in a murine model of acute melioidosis infection to investigate whether chloroquine could be used as an adjunct therapy along with doxycycline for the treatment of melioidosis. Our findings revealed that 50 mg/kg b.w. chloroquine treatment together with a dose of 20 mg/kg b.w. doxycycline improved survivability (100%) of mice infected with 3 X LD50 of B. pseudomallei and significantly (P<0.05) lowered the bacterial loads in spleen, liver and blood compared to controls. B. pseudomallei-infected mice subjected to adjunct treatment with chloroquine and doxycycline significantly (P<0.05) reduced serum levels of pro-inflammatory cytokines (TNF-α, IFN-γ and IL-6) but increased levels of antiinflammatory cytokines (IL-4 and IL-10). Western blot analysis demonstrated that the intensities of pGSK3β (Ser9) in liver samples from mice treated with chloroquine and doxycycline combination were significantly (P<0.05) higher suggesting that the adjunct treatment resulted in significant inhibition of GSK3β. Taken together the bacteriostatic action of doxycycline coupled with the cytokine-modulating effect of chloroquine gave full protection to B. pseudomallei-infected mice and involved inhibition of GSK3β. Findings from the present study using B. pseudomallei-infected BALB/c mice suggest that chloroquine is a plausible candidate for repurposing as adjunct therapy to treat acute B. pseudomallei infection.

Matched MeSH terms: Melioidosis/drug therapy*

Fulltext The man with the boggy head: cranial melioidosis

Kuan YC, How SH, Ng TH, Fauzi AR

Singapore Med J, 2010 Feb;51(2):e43-5.

PMID: 20358143

Melioidosis is known to cause abscesses in various organs, including the cranium, though less commonly. We present a patient with scalp abscess and subdural empyema that was visible on computed tomography of the brain. The neurosurgical drainage grew Burkholderia pseudomallei. Despite our best effort to treat the patient using parenteral antibiotics and surgical drainage, the patient did not survive.

Matched MeSH terms: Melioidosis/drug therapy

Antimicrobial susceptibility patterns of Burkholderia pseudomallei among melioidosis cases in Kedah, Malaysia

Hassan MR, Vijayalakshmi N, Pani SP, Peng NP, Mehenderkar R, Voralu K, et al.

Southeast Asian J Trop Med Public Health, 2014 May;45(3):680-8.

PMID: 24974653

Burkholderia pseudomallei, the causative agent of melioidosis is an important cause of morbidity and mortality particularly among diabetics. We evaluated 228 isolates of B. pseudomallei for antimicrobial sensitivity during 2005-2010 using the disc diffusion technique, of which 144 were obtained from blood culture. More than 90% of the strains were susceptible to cefoperazone, ceftazidime, chloramphenicol and imipenem. Eighty-two percent of the isolates were susceptible to tetracycline and amoxicillin/clavulanate. The susceptibilities to ciprofloxacin was 78% and to trimethoprim-sulfamethoxezole was 47%. The susceptibilities to aminoglycoside antibiotics were low (21% to gentamicin and 6% to amikacin). The susceptibilities were similar between isolates from females and males, bacteremic and abacteremic cases, diabetics and non-diabetics, pneumonia and non-pneumonia cases and between those who died and those who survived. Our findings show antibiotic susceptibility patterns are not a major factor in determining outcomes of B. pseudomallei infection. Monitoring the drug susceptibilities among B. pseudomallei isolates needs to be conducted regularly to guide empiric therapy for melioidosis, as it causes high mortality, especially among diabetic cases.

Matched MeSH terms: Melioidosis/drug therapy

Fulltext Cutaneous melioidosis in a healthy Danish man after travelling to South-East Asia

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/drug therapy

Fulltext Thalassemia major is a major risk factor for pediatric melioidosis in Kota Kinabalu, Sabah, Malaysia

Fong SM, Wong KJ, Fukushima M, Yeo TW

Clin Infect Dis, 2015 Jun 15;60(12):1802-7.

PMID: 25767257 DOI: 10.1093/cid/civ189

Melioidosis is an important cause of community-acquired infection in Southeast Asia and northern Australia. Studies from endemic countries have demonstrated differences in the epidemiology and clinical features among children diagnosed with melioidosis. This suggests that local data are needed to determine the risk factors and outcome in specific areas.

Matched MeSH terms: Melioidosis/drug therapy

Cases of melioidosis in a university teaching hospital in Malaysia

Raja NS

J Microbiol Immunol Infect, 2008 Apr;41(2):174-9.

PMID: 18473106

Melioidosis is an infectious disease caused by Burkholderia pseudomallei that is endemic in Southeast Asia and northern Australia and has also been reported from non-endemic areas of the world. Little is known about the antimicrobial susceptibility pattern and the demography of melioidosis patients in Malaysia.

Matched MeSH terms: Melioidosis/drug therapy

Unrecognised infection in a cystic fibrosis patient

Asiah K, Hanifah YA, Norzila MZ, Hasniah L, Rusanida A

J Paediatr Child Health, 2006 Apr;42(4):217-8.

PMID: 16630326

We report a 17-year-old Malay boy with cystic fibrosis who over a 14-month period experienced worsening respiratory symptoms and deteriorating lung function. Burkholderia pseudomallei was eventually isolated from his sputum. He improved clinically following treatment for meliodosis and his lung function returned to normal.

Matched MeSH terms: Melioidosis/drug therapy

Melioidosis and the vascular surgeon: Hospital Kuala Lumpur experience

Azizi ZA, Yahya M, Lee SK

Asian J Surg, 2005 Oct;28(4):309-11.

PMID: 16234087

Bacterial arteritis is relatively uncommon and management of this condition, which carries high morbidity and mortality, is difficult and time-consuming. Common organisms implicated include Salmonella and Staphylococcus. Arteritis as a result of infection by Burkholderia pseudomallei (formerly Pseudomonas pseudomallei) has been rarely reported in the English literature. This organism, which is endemic in our part of the world, is well known to cause a wide spectrum of septic conditions. A review of cases managed at Hospital Kuala Lumpur revealed that bacterial arteritis due to melioidosis is not such a rare entity. We share our experience in the management of this condition using three cases as examples.

Matched MeSH terms: Melioidosis/drug therapy

Localized melioidosis

Raja NS

J Pak Med Assoc, 2003 Aug;53(8):373-4.

PMID: 14558747

Matched MeSH terms: Melioidosis/drug therapy

Mediastinal melioidosis masquerading as malignancy of the lung

Kho SS, Ho YF, Chan SK, Tie ST

Lancet, 2021 03 13;397(10278):e8.

PMID: 33714391 DOI: 10.1016/S0140-6736(21)00200-2

Matched MeSH terms: Melioidosis/drug therapy*

Melioidosis presenting as prostatitis--a case report from Sabah

Kan SPK, Kay RWW

Trans R Soc Trop Med Hyg, 1978;72(5):522-4.

PMID: 725999 DOI: 10.1016/0035-9203(78)90175-X

Previous reports of melioidosis in Sabah are reviewed and a detailed account of a case, presenting as prostatitis, in a 40-year-old British male is given. The history suggested that the organism, Pseudomonas pseudomallei, was transmitted by a fly which entered the eye. Diagnosis was delayed and treatment presented some difficulty, the organism being relatively insensitive to amplicillin and gentamicin. Co-trimoxazole was the most effective, followed by minocycline. Cure was eventually achieved and after four years the patient was fit and normal, except for sterility.

Matched MeSH terms: Melioidosis/drug therapy

Fulltext Disseminated melioidosis in early pregnancy - an unproven cause of foetal loss

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/drug therapy

Displaying publications 1 - 20 of 38 in total