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World Journal of Clinical Cases 2024年第9期12卷 1669-1676页

作者： Huan-Yu Ni Ying Zhang Dong-Hai Huang Feng Zhou Department of Endocrinology Puren HospitalWuhan University of Science and TechnologyWuhan 430080Hubei ProvinceChina School of Medicine Wuhan University of Science and TechnologyWuhan 430080Hubei ProvinceChina Department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina Department of Rheumatology and Immunology Puren HospitalWuhan University of Science and TechnologyWuhan 430080Hubei ProvinceChina

BACKGROUND melioidosis,an infectious disease caused by Burkholderia pseudomallei(***),occurs endemically in Southeast Asia and Northern Australia and is a serious opportunistic infection associated with a high mortality *** SUMMARY A 58-year-old woman presented with scattered erythema on the skin of her limbs,followed by fever and *** was isolated successively from the patient’s urine,blood,and *** resonance imaging showed abscess formation involving the right forehead and the right frontal ***,abscess resection and drainage were *** patient showed no signs of relapse after 4 months of follow-up visits *** We present here a unique case of multi-systemic melioidosis that occurs in nonendemic regions in a patient who had no recent travel ***,it is critical to enhance awareness of melioidosis in non-endemic regions.

关键词： melioidosis Burkholderia pseudomallei Endemic Diabetes Case report

Multi-systemic melioidosis

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World Journal of Clinical Cases 2024年第28期12卷 6151-6154页

作者： Basavraj S Nagoba Shree V Dhotre Abhijit S Rayate Sachin S Mumbre Pradnya S Dhotre Department of Microbiology Maharashtra Institute of Medical Sciences and Research(Medical College)Latur 413531India Department of Microbiology Ashwini Rural Medical CollegeSolapur 413001India Department of Surgery Maharashtra Institute of Medical Sciences and Research(Medical College)Latur 413531India Department of Community Medicine Ashwini Rural Medical CollegeSolapur 413006India Department of Biochemistry Ashwini Rural Medical CollegeSolapur 413001India

This editorial is a commentary on the article by Ni et al,which was published in the World Journal of Clinical *** article discusses the diagnostic and therapeutic challenges of melioidosis caused by Burkholderia *** case study highlights a rare instance of multisystemic melioidosis in a female patient who did not have a travel history,emphasizing the significance of recognizing this condition in non-endemic *** complexities and therapeutic strategies are addressed,emphasizing the need for heightened clinical suspicion,comprehensive evaluation,and multidisciplinary *** editorial delves into the clinical presentation,diagnostic dilemmas,therapeutic approaches,and their implications for patient care in managing multi-systemic melioidosis.

关键词： melioidosis Burkholderia pseudomallei Multi-systemic Diagnosis Treatment

Comparison of Cox proportional hazards model,Cox proportional hazards with time-varying coefficients model,and lognormal accelerated failure time model:Application in time to event analysis of melioidosis patients

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Asian Pacific Journal of Tropical Medicine 2022年第3期15卷 128-134页

作者： Kamaruddin Mardhiah Nadiah Wan-Arfah Nyi Nyi Naing Muhammad Radzi Abu Hassan Huan-Keat Chan Faculty of Entrepreneurship and Business Universiti Malaysia KelantanKota BharuKelantanMalaysia Faculty of Health Sciences Universiti Sultan Zainal AbidinKuala TerengganuTerengganuMalaysia Faculty of Medicine Universiti Sultan Zainal AbidinKuala TerengganuTerengganuMalaysia Clinical Research Center Hospital Sultanah BahiyahMinistry of Health MalaysiaAlor SetarKedahMalaysia

Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)***:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to Hospital Sultanah Bahiyah,Kedah and Hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured *** prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit *** analyses were done by using Stata SE version ***:A total of 242 patients(53.4%)*** this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC *** AFT survival analysis,a total of seven significant prognostic factors were *** results were found to be only a slight difference between the identified prognostic factors among the *** survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell ***:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.

关键词： Cox proportional hazards Time-dependent Time-varying Accelerated failure time survival analysis Lognormal Parametric model Time-to-event melioidosis Mortality

melioidosis in India and Bangladesh: A review of case reports

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Asian Pacific Journal of Tropical Medicine 2018年第5期11卷 320-329页

作者： Meghan Tipre Paul Vijay Kingsley Tamika Smith Mark Leader Nalini Sathiakumar Department of Epidemiology School of Public HealthUniversity of Alabama Pantai Hospital Ipoh

Objective: To conduct an epidemiological and clinical review of published case reports of melioidosis from India and Bangladesh. Methods: Data from published case reports were abstracted and summarized. We further compared the clinical epidemiology of the melioidosis cases in India with case series from highly endemic areas in Northern Australia and Southeast Asia to elucidate any differences in presentations and risk factors between the ***: We identified a total of 99 cases published between 1953 and June 2016, originating from India(n=85) or Bangladesh(n=14). Cases were predominantly male and ranged in age from 1 month to 90 years. Diabetes mellitus was the most common risk factor reported(58%). About 28% of the cases had history of exposure via high-risk occupations or exposure to contaminated water. The overall case fatality rate(CFR) was 26%. Factors influencing mortality included the occurrence of septic shock(CFR, 80%), environmental exposure(CFR,39%), primary presentation of pneumonia(CFR, 38%), misdiagnosed and/or mistreated cases(CFR, 33%) or the presence of a risk factor(CFR, 29%). Because of the small number of cases in Bangladesh, pattern of clinical epidemiology is limited to India. Soft tissue abscess(37%)was the most common clinical presentation reported from India followed by pneumonia(24%)and osteomyelitis/septic arthritis(18%). Neurological melioidosis(n=10, 12%) presented as pyemic lesions of the brain or meninges. A few cases of prostatic abscess(n=4) in men and parotid abscess(n=4) were also noted. The above patterns were consistent with case series from Southeast Asia and Northern Australia for the most part, in terms of risk factors associated with infection and factors influencing mortality. Differences included clinical presentation of pneumonia which was notably lower than that reported in Southeast Asia and Northern Australia; a higher proportion of neurological and parotid abscess presentation; and a lower CFR compared to th

关键词： melioidosis India Bangladesh Burkholderia pseudomallei Environmental

melioidosis an Imported Infection in Qatar: Case Series and Literature Review

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Advances in Infectious Diseases 2022年第2期12卷 175-192页

作者： Mohammed Abu Khattab Mohamed Abou Kamar Adham Darweesh Anand Deshmukh Infectious Disease Division Department of Medicine Hamad General Hospital Doha Qatar Radiology Department Hamad General Hospital Doha Qatar Microbiology Department University Hospital Coventry and Warwickshire NHS Trust Coventry UK

Introduction: melioidosis is a tropical infectious disease caused by Gramnegative bacteria Burkholderia pseudomallei (B. pseudomallei). This soil-borne disease is endemic in Southeast Asia and Northern Australia. In our country it was reported once before in 2000 in a patient who presented with subdural empyema. Case Series Report: We are reporting six cases of melioidosis presented to our hospital in very close time with different clinical presentations. All patients were from Indian subcontinent. In 3 cases we treated with Meropenem plus Trimethoprim-Sulfamethoxazole (TMP-SMX) followed by oral TMP-SMX and Doxycycline for around 6 months with good clinical and radiological response, while the fourth case was treated with oral TMP-SMX and Doxycycline for 1 month but he lost to follow up, the Fifth cases were treated with IV Ceftazidime followed by TMP-SMX and Doxycycline for 9 weeks, the Sixth cases were treated with IV Ceftazidime followed by TMP-SMX and Amoxicillin/Clavulanic acid for 20 days, there was no mortality reported in our case series for both types Bactraemic and Abactraemic melioidosis. Conclusions: This case series highlights the importance of early identification of B. pseudomallei which requires a high index of clinical suspicion as well as good understanding of demographical and travel history. Microbiological identification of B. pseudomallei is essential and requires notification of the microbiologist for suspicion of that infection. Prolonged antimicrobial therapy is required for a better clinical outcome.

关键词： melioidosis Bactraemic Abactraemic melioidosis Burkholderia pseudomallei Infection

melioidosis:a rare cause of anterior chest wall abscess

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Asian Pacific Journal of Tropical Medicine 2010年第3期3卷 241-243页

作者： Rashidi Ahmad Azhar Amir Hamzah Ahmad Kasfi Abdul Rahman Phee Kheng Cheah Department of Emergency Medicine School of Medical SciencesUSM Health Campus Department of Surgery School of Medical SciencesUSM Health Campus Infectious Unit Department of MedicineHospital Kuala Terengganu

melioidosis is an unusual tropical infectious disease caused by the gram-negative bacterium Burkholderia pseudomallei,which was formerly known as Pseudomonas pseudomallei. melioidosis is characterized by abscess formation and it may manifest in any part of the human body,however,musculoskeletal melioidosis is uncommon and chest wall melioidosis is very rare. To determine the exact organism based solely on clinical presentation poses a great challenge to the ***,delay administration of antibiotic may be *** describe a diabetic patient who had anterior chest wall melioidosis that mimics Staphylococcus aureus infection.A description of his presentation and management,along with a review of literature is presented.

关键词： melioidosis Chest wall abscess Diagnositic challenge

Predictors of in-hospital mortality by logistic regression analysis among melioidosis patients in Northern Malaysia:A retrospective study

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Asian Pacific Journal of Tropical Medicine 2021年第8期14卷 356-363页

作者： Kamaruddin Mardhiah Nadiah Wan-Arfah Nyi Nyi Naing Muhammad Radzi Abu Hassan Huan-Keat Chan Faculty of Entrepreneurship and Business Universiti Malaysia KelantanKota BharuKelantanMalaysia Faculty of Health Sciences Universiti Sultan Zainal AbidinGong Badak CampusKuala TerengganuTerengganuMalaysia Faculty of Medicine Universiti Sultan Zainal AbidinKuala TerengganuTerengganuMalaysia Clinical Research Center Hospital Sultanah BahiyahMinistry of Health MalaysiaAlor SetarKedahMalaysia

Objective:To identify the predictors of mortality among in-hospital melioidosis ***:A total of 453 patients in Hospital Sultanah Bahiyah,Kedah,and Hospital Tuanku Fauziah,Perlis with culture-confirmed melioidosis were retrospectively included in the *** multiple logistic regression was used to obtain the final model of predictors of mortality from *** analysis was performed using STATA/SE ***:A total of 50.11%(227/453)of the patients died at the hospital,and a majority(86.75%,393/453)of cases were *** logistic regression estimated that the bacteremic type of melioidosis,low platelet count,abnormal white blood cell counts,and increased urea value were predictors of *** results showed that bacteremic melioidosis increased the risk of death by 4.39 times(OR 4.39,95%CI 1.83-10.55,P=0.001)compared to non-bacteremic *** on laboratory test,the adjusted ORs from the final model showed that all three blood investigations were included as the associated factors of mortality for the disease[high white blood cell(>10×10^(9)/L):OR 2.43,95%CI1.41-4.17,P7800μmol/L):OR 5.53,95%CI 2.50-12.30,Pmelioidosis patients.

关键词： melioidosis Infectious disease Mortality Predictors Prognostic factors Logistic model

Analysis of a mathematical model for the transmission dynamics of human melioidosis

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International Journal of Biomathematics 2020年第7期13卷 109-131页

作者： Yibeltal Adane Terefe Semu Mitiku Kassa Department of Mathematics and Applied Mathematics University of Limpopo South Africa Department of Mathematics and Statistical Sciences Botswana International University of Science and Technology Botswana

A deterministic model for the transmission dynamics of melioidosis disease in human population is designed and *** model is shown to exhibit the phenomenon of backward bifurcation,where a stable disease-free equilibrium co-exists with a stable endemic equilibrium when the basic reproduction number R_(0) is less than *** is further shown that the backward bifurcation dynamics is caused by the reinfection of individuals who recovered from the disease and *** existence of backward bifurcation implies that bringing down R_(0) to less than unity is not enough for disease *** the absence of backward bifurcation,the global asymptotic stability of the disease-free equilibrium is shown whenever R_(0)1,the existence of at least one locally asymptotically stable endemic equilibrium is *** analysis of the model,using the parameters relevant to the transmission dynamics of the melioidosis disease,is *** experiments are presented to support the theoretical analysis of the *** the numerical experimentations,it has been observed that screening and treating individuals in the exposed class has a significant impact on the disease dynamics.

关键词： melioidosis bifurcation reinfection reproduction number stability sensitivity analysis

Pitfalls and optimal approaches to diagnose melioidosis

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Asian Pacific Journal of Tropical Medicine 2016年第6期9卷 501-510页

作者： Paul Vijay Kingsley Govindakarnavar Arunkumar Meghan Tipre Mark Leader Nalini Sathiakumar Sultan Ismail Hospital Manipal Center for Virus Research Manipal University School of Public Health University of Alabama at Birmingham

melioidosis is a severe and fatal infectious disease in the tropics and subtropics. It presents as a febrile illness with protean manifestation ranging from chronic localized infection to acute fulminant septicemia with dissemination of infection to multiple organs characterized by abscesses. Pneumonia is the most common clinical presentation. Because of the wide range of clinical presentations, physicians may often misdiagnose and mistreat the disease for tuberculosis, pneumonia or other pyogenic infections. The purpose of this paper is to present common pitfalls in diagnosis and provide optimal approaches to enable early diagnosis and prompt treatment of melidoidosis. melioidosis may occur beyond the boundaries of endemic areas. There is no pathognomonic feature specific to a diagnosis of melioidosis. In endemic areas, physicians need to expand the diagnostic work-up to include melioidosis when confronted with clinical scenarios of pyrexia of unknown origin, progressive pneumonia or sepsis. Radiological imaging is an integral part of the diagnostic workup. Knowledge of the modes of transmission and risk factors will add support in clinically suspected cases to initiate therapy. In situations of clinically highly probable or possible cases where laboratory bacteriological confirmation is not possible, applying evidence-based criteria and empirical treatment with antimicrobials is recommended. It is of prime importance that patients undergo the full course of antimicrobial therapy to avoid relapse and recurrence. Early diagnosis and appropriate management is crucial in reducing serious complications leading to high mortality, and in preventing recurrences of the disease. Thus, there is a crucial need for promoting awareness among physicians at all levels and for improved diagnostic microbiology services. Further, the need for making the disease notifiable and/or initiating melioidosis registries in endemic countries appears to be compelling.

关键词： melioidosis pseudomallei Review Diagnosis Treatment Pitfalls Approaches route of infection

Characteristics,clinical outcomes and factors influencing mortality of patients with melioidosis in southern Thailand:a 10-year retrospective study

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Asian Pacific Journal of Tropical Medicine 2016年第3期9卷 250-255页

作者： Chaitong Churuangsuk Sarunyou Chusri Thanaporn Hortiwakul Boonsri Charernmak Kachornsakdi Silpapojakul Department of Internal Medicine.Faculty of Medicine.Prince of Songkla University Epidemiology Unit Faculty of MedicinePrince of Songkla University

Objective:To study characteristics,clinical outcomes and factors influencing mortality of patients afflicted with ***:A total of 134 patients were retrospectively analyzed with a microbiologically-confirmed diagnosis of melioidosis,during the period from January 2002 to June 2011 at Songklanagarind Hospital,a tertiary care hospital in southern ***:The prevalence of melioidosis among admitted patients was 36.8 per100000 in *** median age was 49 years and they were predominantly *** most common underlying disease was diabetes mellitus(47.01%).The majority of cases(50%)had localized *** rates of multifocal,bacteremic,and disseminated infections were12.7%.23.1%.and 14.2%.*** lungs were the most common organ afflicted,resulting in infection(24.63%).Splenic abscess as well as liver abscess accounted for 20.90%and 19.40%.respectively.A total of one eighth of the patients had septic shock at *** overall mortality rate was 8.96%.The factors influencing mortality were pneumonia,septic shock,a positive blood culture for Burkholderia *** with nosocomial infection and inappropriate antibiotic ***:melioidosis is not uncommon in southern *** mortality of patients with pneumonia,bacteremia and septic shock is relatively *** antibiotics,initially,will improve outcomes.

关键词： melioidosis Southern Thailand Burkholderia pseudomallei