Lim W K, Gurdeep G S, Norain K
ENT Department, Hospital Ipoh, Perak.
Med J Malaysia. 2001 Dec;56(4):471-7.
Melioidosis is a potentially deadly infection that can affect any organ system. Reports of melioidosis of the ENT/head and neck region are relatively uncommon. Four cases are presented: (i) parotid abscess evolving into necrotising fasciitis, (ii) acute sinusitis and parapharyngeal cellulitis resulting in upper airway obstruction, (iii) acute suppurative lymphadenitis (iv) and chronic suppurative otitis media causing meningoencephalitis. Three of the four cases are believed to be unique, as a literature review of melioidosis in ENT/head and neck is also presented. Some practical issues of management are also discussed. Not suspecting melioidosis does not change contemporary empirical broadspectrum antibiotic therapy. The value of suspicion or on confirmation of diagnosis lies in anticipating and planning for rapid change.
类鼻疽是一种可能致命的感染，可累及任何器官系统。耳鼻喉/头颈部类鼻疽的报告相对少见。本文介绍4例：（i）腮腺脓肿演变为坏死性筋膜炎，（ii）急性鼻窦炎和咽旁蜂窝织炎导致上呼吸道梗阻，（iii）急性化脓性淋巴结炎，（iv）慢性化脓性中耳炎导致脑膜脑炎。这4例中的3例据信是独特的，因为本文还对耳鼻喉/头颈部类鼻疽进行了文献综述。还讨论了一些实际的管理问题。不怀疑类鼻疽并不改变当代经验性广谱抗生素治疗。怀疑或确诊的价值在于预期并计划快速改变。
