Mathew S, Perakath B, Mathew G, Sitaram V, Nair A, Lalitha M K, John T J
Christian Medical College, Vellore, Tamil Nadu, India.
Natl Med J India. 1999 Mar-Apr;12(2):59-61.
Melioidosis, the disease caused by Burkholderia pseudomallei, is common in Southeast Asia. It has also been reported from India, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites.
All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated.
Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed.
Melioidosis is under-diagnosed in India, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent.
类鼻疽病由类鼻疽伯克霍尔德菌引起，在东南亚地区较为常见。印度也有相关报道，一些研究人员认为该病在印度存在诊断不足和报告不充分的情况。我们报告了以不寻常部位脓肿形式出现的类鼻疽病的诊治经验。
对1995年至1998年间在单个外科病房就诊且经培养证实感染类鼻疽伯克霍尔德菌的所有连续患者进行评估。
3例患者表现为脾脓肿，1例表现为颈部软组织脓肿。1例患者发生败血症。所有患者在确诊后立即开始使用头孢他啶和/或复方新诺明治疗，反应良好。
类鼻疽病在印度诊断不足，可能是由于临床医生对该病的怀疑指数较低。当在不寻常部位发现脓肿时，应考虑到类鼻疽病的可能性。然后必须对脓液进行培养以确定病原体。
