Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review

  • Zakuan Zainy Deris School of Medical Sciences, Universiti Sains Malaysia,Kubang Kerian, Kelantan, Malaysia
  • Habsah Hasan Hospital Universiti Sains Malaysia,Kubang Kerian, Kelantan, Malaysia
  • Mohd Noor Siti Suraiya School of Medical Sciences, Universiti Sains Malaysia,Kubang Kerian, Kelantan, Malaysia
Keywords: melioidosis, clinical features, Malaysia

Abstract

Background: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia.

Methodology: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia.

Results: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission.

Conclusions: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

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Author Biographies

Zakuan Zainy Deris, School of Medical Sciences, Universiti Sains Malaysia,Kubang Kerian, Kelantan, Malaysia

Lecturer

Department of Medical Microbiology and Parasitology,           School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan,       Malaysia
Habsah Hasan, Hospital Universiti Sains Malaysia,Kubang Kerian, Kelantan, Malaysia
Epidemiolgy and Infection Control Unit, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Mohd Noor Siti Suraiya, School of Medical Sciences, Universiti Sains Malaysia,Kubang Kerian, Kelantan, Malaysia

Lecturer

Department of Medical Microbiology and Parasitology,           School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan,       Malaysia
Published
2010-05-09
How to Cite
1.
Deris ZZ, Hasan H, Siti SuraiyaMN (2010) Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review. J Infect Dev Ctries 4:430-435. doi: 10.3855/jidc.491
Section
Original Articles