Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T17:32:38.210Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical presentation and treatment of melioidosis in the head and neck region

Published online by Cambridge University Press:  05 September 2018

K Mahawerawat  and
P Kasemsiri
K Mahawerawat
Affiliation:
Department of Otorhinolaryngology, Mukdahan Hospital, Thailand
P Kasemsiri*
Affiliation:
Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine at Khon Kaen University, Thailand
*
Author for correspondence: Dr Pornthep Kasemsiri, Skull Base Surgery Unit, Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine at Khon Kaen University, Khon Kaen 40002, Thailand E-mail: [email protected] Fax: +66 43 202 490
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Although melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.

Objectives

To report the clinical presentation and management of melioidosis in the head and neck.

Method

A retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.

Results

Medical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35–88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47–98.80).

Conclusion

Careful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.

Keywords

Burkholderia PseudomalleiMelioidosisParotitisLymphadenitis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 827 - 831
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr P Kasemsiri takes responsibility for the integrity of the content of the paper

References

1Chaowagul, W, White, NJ, Dance, DA, Wattanagoon, Y, Naigowit, P, Davis, TM et al. Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. J Infect Dis 1989;159:890–9Google Scholar
2Suputtamongkol, Y, Hall, AJ, Dance, DA, Chaowagul, W, Rajchanuvong, A, Smith, MD et al. The epidemiology of melioidosis in Ubon Ratchatani, northeast Thailand. Int J Epidemiol 1994;23:1082–90Google Scholar
3Tanwisaid, K, Surin, U. Monthly rainfall and severity of melioidosis in Nakhon Phanom, Northeastern Thailand. J Health Sci 2008;17:363–75Google Scholar
4Lim, WK, Gurdeep, GS, Norain, K. Melioidosis of the head and neck. Med J Malaysia 2001;56:471–7Google Scholar
5Loh, TL, Latis, S, Crossland, G, Patel, H. Disseminated melioidosis in the head and neck. BMJ Case Rep 2017;2017:bcr2016218606Google Scholar
6Phillips, NM, Cervin, A, Earnshaw, J, Sidjabat, HE. Melioidosis in a patient with chronic rhinosinusitis. J Laryngol Otol 2016;130(suppl 4):S60–2Google Scholar
7Limmathurotsakul, D, Jamsen, K, Arayawichanont, A, Simpson, JA, White, LJ, Lee, SJ et al. Defining the true sensitivity of culture for the diagnosis of melioidosis using Bayesian latent class models. PLoS One 2010;5:e12485Google Scholar
8Wiersinga, WJ, Currie, BJ, Peacock, SJ. Melioidosis. N Engl J Med 2012;367:1035–44Google Scholar
9Foong, YC, Tan, M, Bradbury, RS. Melioidosis: a review. Rural Remote Health 2014;14:2763Google Scholar
10Suttisunhakul, V, Chantratita, N, Wikraiphat, C, Wuthiekanun, V, Douglas, Z, Day, NP et al. Evaluation of polysaccharide-based latex agglutination assays for the rapid detection of antibodies to Burkholderia pseudomallei. Am J Trop Med Hyg 2015;93:542–6Google Scholar
11Teparrugkul, P. Indirect hemagglutination test for the diagnosis of melioidosis in Ubon Ratchathani. J Infect Dis Antimicrob Agents 1997;14:17–19Google Scholar
12Kohler, C, Dunachie, SJ, Müller, E, Kohler, A, Jenjaroen, K, Teparrukkul, P et al. Rapid and sensitive multiplex detection of Burkholderia pseudomallei-specific antibodies in melioidosis patients based on a protein microarray approach. PLoS Negl Trop Dis 2016;10:e0004847Google Scholar
13Dance, D. Treatment and prophylaxis of melioidosis. Int J Antimicrob Agents 2014;43:310–18Google Scholar
14Dutta, S, Haq, S, Hasan, MR, Haq, JA. Antimicrobial susceptibility pattern of clinical isolates of Burkholderia pseudomallei in Bangladesh. BMC Res Notes 2017;10:299Google Scholar
15Ahmad, N, Hashim, R, Mohd Noor, A. The in vitro antibiotic susceptibility of Malaysian isolates of Burkholderia pseudomallei. Int J Microbiol 2013;2013:121845Google Scholar
16Fisher, DA, Harris, PN. Melioidosis: refining management of a tropical time bomb. Lancet 2014;383:762–4Google Scholar
17Cheng, AC, Chierakul, W, Chaowagul, W, Chetchotisakd, P, Limmathurotsakul, D, Dance, DA et al. Consensus guidelines for dosing of amoxicillin-clavulanate in melioidosis. Am J Trop Med Hyg 2008;78:208–9Google Scholar
18Limmathurotsakul, D, Chaowagul, W, Chierakul, W, Stepniewska, K, Maharjan, B, Wuthiekanun, V et al. Risk factors for recurrent melioidosis in northeast Thailand. Clin Infect Dis 2006;43:979–86Google Scholar