Department of Orthopaedics, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam.
Singapore Med J. 2011 May;52(5):346-50.
Melioidosis caused by Burkholderia pseudomallei is an infectious disease endemic to Southeast Asia and northern Australia. It has a broad spectrum of clinical manifestations and high mortality, and can mimic other infectious diseases. The aim of this study was to review cases of melioidosis of the extremities in Brunei Darussalam.
Culture-positive cases for Burkholderia pseudomallei in Raja Isteri Pengiran Anak Saleha Hospital were identified from records in the Microbiology Department. The case notes were reviewed to identify patients who were treated for problems affecting the extremities. 14 (13 males and one female) out of 48 patients were identified.
The median age of the patients was 45 (range 14-55) years. Septicaemia was the most common presenting feature in 11 patients. Multisystem involvement was noted in eight patients, diabetes mellitus in nine patients and other risk factors in two patients. Blood culture was positive in ten patients and pus culture in 11 patients. The presentations noted were cellulitis of the limbs, abscess, osteomyelitis (three patients each) and septic arthritis (five patients). Orthopaedic intervention (joint washout/incision and drainage/curettage) was required in 11 patients. The median hospital stay was 27.5 (range 13-63) days; two patients required admission to intensive care. No mortality was reported.
Melioidosis of the extremities is not uncommon in Brunei Darussalam. It is associated with significant morbidity, and a large number of patients require surgical intervention. Thus, a high index of suspicion is required for early diagnosis and institution of appropriate antibiotic therapy.
由伯克霍尔德菌引起的类鼻疽病是一种在东南亚和澳大利亚北部流行的传染病。它具有广泛的临床表现和高死亡率，可以模仿其他传染病。本研究旨在回顾文莱达鲁萨兰国的四肢类鼻疽病例。
从微生物学系的记录中确定 Raja Isteri Pengiran Anak Saleha 医院中伯克霍尔德菌假单胞菌的培养阳性病例。回顾病例记录，以确定治疗影响四肢的疾病的患者。在 48 名患者中，发现了 14 名（13 名男性和 1 名女性）患者。
患者的中位年龄为 45 岁（范围为 14-55 岁）。败血症是 11 名患者最常见的首发症状。8 名患者存在多系统受累，9 名患者患有糖尿病，2 名患者存在其他危险因素。10 名患者的血液培养呈阳性，11 名患者的脓液培养呈阳性。注意到的表现为四肢蜂窝织炎、脓肿、骨髓炎（各 3 例）和化脓性关节炎（5 例）。11 名患者需要进行骨科干预（关节冲洗/切开引流/刮除术）。中位住院时间为 27.5 天（范围为 13-63 天）；2 名患者需要入住重症监护病房。无死亡报告。
文莱达鲁萨兰国的四肢类鼻疽并不少见。它与显著的发病率相关，大量患者需要手术干预。因此，需要高度怀疑早期诊断和适当的抗生素治疗。
