Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-24T14:05:39.507Z Has data issue: false hasContentIssue false
  • English
  • Français

Melioidosis and the vacuum-assisted closure device: a rare cause of a discharging neck wound, and a new approach to management

Published online by Cambridge University Press:  11 March 2010

G Garas ,
S Ifeacho ,
R Millard  and
N Tolley
G Garas*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
S Ifeacho
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
R Millard
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
N Tolley
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
*
Address for correspondence: Dr George Garas, Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, Praed Street, London W2 1NY, UK. Fax: +44 207 886 6666 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We report a case of melioidosis presenting as a discharging neck abscess, and we describe the use of a vacuum-assisted closure device in its management.

Method:

We report the case of a 44-year-old, Afro-Caribbean woman with melioidosis. We also present the results of a literature search using the search terms ‘melioidosis’, ‘Burkholderia pseudomallei’ and ‘vacuum-assisted closure device’.

Results:

Microbiological analysis identified the causative organism as being the bacterium Burkholderia pseudomallei, and its antimicrobial sensitivities to imipenem and ciprofloxacin. A vacuum-assisted closure device was used to manage the patient's melioidosis of the neck; we believe this is the first report of such treatment.

Conclusions:

Melioidosis is rare in the UK and western world; however, exposure can occur during travel to endemic areas. We therefore draw attention to this infection as part of the differential diagnosis of a neck abscess. We propose the use of vacuum-assisted closure devices as useful adjuncts to the management of discharging neck wounds.

Keywords

MelioidosisBurkholderia PseudomalleiVacuum Pump
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 1021 - 1024
Copyright
Copyright © JLO (1984) Limited 2010

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.)

References

1Zulkiflee, AB, Prepageran, N, Philip, R. Melioidosis: an uncommon cause of neck abscess. Am J Otolaryngol 2008;29:72–4CrossRefGoogle ScholarPubMed
2Inglis, TJ, Rolim, DB, Rodriguez, JL. Clinical guideline for diagnosis and management of melioidosis. Rev Inst Med Trop Sao Paulo 2006;48:1–4CrossRefGoogle ScholarPubMed
3Ma, TL, Huang, GC, Tang, HJ, Chang, CM. Melioidotic necrotizing fasciitis presenting as a supraclavicular mass. Jpn J Infect Dis 2008;61:151–3CrossRefGoogle ScholarPubMed
4Andrews, BT, Smith, RB, Goldstein, DP, Funk, GF. Management of complicated head and neck wounds with vacuum-assisted closure system. Head Neck 2006;28:974–81CrossRefGoogle ScholarPubMed
5Marathe, US, Sniezek, JC. Use of the vacuum-assisted closure device in enhancing closure of a massive skull defect. Laryngoscope 2004;114:961–4CrossRefGoogle ScholarPubMed
6Rosenthal, EL, Blackwell, KE, McGrew, B, Carroll, WR, Peters, GE. Use of negative pressure dressings in head and neck reconstruction. Head Neck 2005;27:970–5CrossRefGoogle ScholarPubMed
7Thomas, J, Jayachandran, NV, Shenoy Chandrasekhara, PK, Lakshmi, V, Narsimulu, G. Melioidosis – an unusual cause of septic arthritis. Clin Rheumatol 2008;27(suppl 2):S59–61CrossRefGoogle ScholarPubMed
8Gibney, KB, Cheng, AC, Currie, BJ. Cutaneous melioidosis in the tropical top end of Australia: a prospective study and review of the literature. Clin Infect Dis 2008;47:603–9CrossRefGoogle Scholar
9Raja, NS. Cases of melioidosis in a university teaching hospital in Malaysia. J Microbiol Immunol Infect 2008;41:174–9Google Scholar
10Aldhous, P. Tropical medicine: melioidosis? Never heard of it. Nature 2005;434:692–3CrossRefGoogle Scholar
11Cheng, AC, Currie, BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 2005;18:383–416CrossRefGoogle ScholarPubMed
12Borgherini, G, Poubeau, P, Paganin, F, Picot, S, Michault, A, Thibault, F et al. Melioidosis: an imported case from Madagascar. J Travel Med 2006;13:318–20CrossRefGoogle ScholarPubMed
13Currie, BJ. Advances and remaining uncertainties in the epidemiology of Burkholderia pseudomallei and melioidosis. Trans R Soc Trop Med Hyg 2008;102:225–7CrossRefGoogle ScholarPubMed
14Muthusamy, KA, Waran, V, Puthucheary, SD. Spectra of central nervous system melioidosis. J Clin Neurosci 2007;14:1213–15CrossRefGoogle ScholarPubMed
15Chan, KP, Low, JG, Raghuram, J, Fook-Chong, SM, Kurup, A. Clinical characteristics and outcome of severe melioidosis requiring intensive care. Chest 2005;128:3674–8CrossRefGoogle ScholarPubMed
16Heng, BH, Goh, KT, Yap, EH, Loh, H, Yeo, M. Epidemiological surveillance of melioidosis in Singapore. Ann Acad Med Singapore 1998;27:478–84Google ScholarPubMed
17Tan, AL, Ang, BS, Ong, YY. Melioidosis: epidemiology and antibiogram of cases in Singapore. Singapore Med J 1990;31:335–7Google ScholarPubMed
18Kumar, GS, Raj, PM, Chacko, G, Lalitha, MK, Chacko, AG, Rajshekhar, V. Cranial melioidosis presenting as a mass lesion or osteomyelitis. J Neurosurg 2008;108:243–7CrossRefGoogle ScholarPubMed
19Huis in 't, Veld D, Wuthiekanun, V, Cheng, AC, Chierakul, W, Chaowagul, W, Brouwer, AE et al. The role and significance of sputum cultures in the diagnosis of melioidosis. Am J Trop Med Hyg 2005;73:657–61Google Scholar
20Woods, ML, Currie, BJ, Howard, DM, Tierney, A, Watson, A, Anstey, NM et al. Neurological melioidosis: seven cases from the Northern Territory of Australia. Clin Infect Dis 1992;15:163–9CrossRefGoogle ScholarPubMed
21Baumann, BB, Morita, ET. Systemic melioidosis presenting as myocardial infarct. Ann Intern Med 1967;67:836–42CrossRefGoogle ScholarPubMed
22Currie, BJ, Fisher, DA, Howard, DM, Burrow, JN, Lo, D, Selva-Nayagam, S et al. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 2000;31:981–6CrossRefGoogle Scholar
23Kiertiburanakul, S, Sungkanuparph, S, Kositchiwat, S, Vorachit, M. Burkholderia pseudomallei: abscess in an unusual site. J Postgrad Med 2002;48:124–6Google Scholar
24Sivalingam, SP, Sim, SH, Jasper, LC, Wang, D, Liu, Y, Ooi, EE. Pre- and post-exposure prophylaxis of experimental Burkholderia pseudomallei infection with doxycycline, amoxicillin/clavulanic acid and co-trimoxazole. J Antimicrob Chemother 2008;61:674–8CrossRefGoogle ScholarPubMed
25Argenta, LC, Morykwas, MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 1997;38:563–76CrossRefGoogle ScholarPubMed
26Morykwas, MJ, Argenta, LC, Shelton-Brown, EI, McGuirt, W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 1997;38:553–62CrossRefGoogle ScholarPubMed
27DeFranzo, AJ, Argenta, LC, Marks, MW, Molnar, JA, David, LR, Webb, LX et al. The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg 2001;108:1184–91CrossRefGoogle ScholarPubMed
28Harlan, JW. Treatment of open sternal wounds with the vacuum-assisted closure system: a safe, reliable method. Plast Reconstr Surg 2002;109:710–12CrossRefGoogle ScholarPubMed
29Hopf, HW, Humphrey, LM, Puzziferri, N, West, JM, Attinger, CE, Hunt, TK. Adjuncts to preparing wounds for closure: hyperbaric oxygen, growth factors, skin substitutes, negative pressure wound therapy (vacuum-assisted closure). Foot Ankle Clin 2001;6:661–82CrossRefGoogle ScholarPubMed
30Mendez-Eastman, S. Negative pressure wound therapy. Plast Surg Nurs 1998;18:27–29CrossRefGoogle ScholarPubMed
31Sibbald, RG, Mahoney, J. A consensus report on the use of vacuum-assisted closure in chronic, difficult-to-heal wounds. Ostomy Wound Manage 2003;49:52–66Google ScholarPubMed
32Song, DH, Wu, LC, Lohman, RF, Gottlieb, LJ, Franczyk, M. Vacuum assisted closure for the treatment of sternal wounds: the bridge between debridement and definitive closure. Plast Reconstr Surg 2003;111:92–7CrossRefGoogle Scholar