Details

Autor(en) / Beteiligte

• Perez, Anthony R.
• Aburayyan, Nour
• Sto. Domingo, Manuel Ramon
• Onglao, Mark

Titel

Disseminated Melioidosis presenting as pneumonia, femoral and sacral osteomyelitis, splenic abscess and high rectal fistula: A case report and review of literature

Ist Teil von

• International journal of surgery case reports, 2021-12, Vol.89, p.106588-106588, Article 106588

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2021

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Melioidosis is a rare infectious tropical disease caused by Burkholderia pseudomallei (B. pseudomallei), an environmental saprophyte usually habitating on soils of Southeast Asian fields. Most of the reported cases present with pneumonia and intra-abdominal abscess. Diagnosis is established by culture studies from the blood, sputum or abscess drainage. Management relies on culture-guided antibiotic treatment, with good prognosis. Surgical intervention is required in cases not responsive to medical management. We are presenting a case of Melioidosis in a 72 year old Filipino who presented with Pneumonia, Femoral and Sacral Osteomyelitis, Splenic Abscess and High Rectal Fistula. He was successfully managed with systemic antibiotic treatment and surgery. The splenic abscess was managed by splenectomy and a transverse loop colostomy was used for fecal diversion to address the rectal fistula. Melioidosis varies in its presentation and thus management should be individualized, depending on the organs involved. Our patient presented with multiple foci of infection which rendered the treatment more complicated as compared to those reported previously in published literature. The pneumonia and the osteomyelitis were managed with aggressive systemic antibiotics but the other sites of infection required drainage and surgery. Melioidosis is a rare infection caused by an environmental saprophyte Burkholderia pseudomallei. An accurate diagnosis using culture studies is essential to institute appropriate treatment. Antibiotic treatment complemented by surgery for specific organ involvement is essential for cure. •Melioidosis is a rare disease caused by Burkholderia pseudomallei, common in the soil of tropical islands in Southeast Asia.•It’s presentation is diverse, with most of the reported cases presenting with pneumonia and intra-abdominal abscess.•Diagnosis is established by culture studies from the blood, sputum or abscess drainage.•Management relies on culture-guided antibiotic treatment, with good prognosis.•Surgical intervention is required in cases not responsive to medical management.