Shetty Hariprasad Sadanand, Mallela Ajay Raj, Shastry Barkur Ananthakrishna, Acharya Vasudeva
Department of Internal Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
BMJ Case Rep. 2015 Feb 27;2015:bcr2014208612. doi: 10.1136/bcr-2014-208612.
We report a case of a 55-year-old man with uncontrolled diabetes who presented with pneumonia. During his hospital stay his clinical status worsened and he had a focal seizure. MRI showed central nervous system involvement and parietal bone osteomyelitis. As the patient's blood culture and endotracheal aspirate grew Burkholderia pseudomallei, melioidosis was diagnosed. He was treated with meropenem after failure to respond to ceftazidime. He gradually improved over a period of 4 weeks and was discharged. Early diagnosis and therapy resulted in improved outcome.
我们报告一例55岁男性，患有未得到控制的糖尿病，因肺炎就诊。在住院期间，其临床状况恶化，并出现局灶性癫痫发作。磁共振成像（MRI）显示中枢神经系统受累及顶骨骨髓炎。由于患者血培养及气管内吸出物培养出类鼻疽伯克霍尔德菌，故诊断为类鼻疽。在对头孢他啶治疗无反应后，改用美罗培南治疗。他在4周内逐渐好转并出院。早期诊断和治疗使预后得到改善。
