Schully Kevin L, Berjohn Catherine M, Prouty Angela M, Fitkariwala Amitha, Som Tin, Sieng Darith, Gregory Michael J, Vaughn Andrew, Kheng Sim, Te Vantha, Duplessis Christopher A, Lawler James V, Clark Danielle V
Naval Medical Research Center, Biological Defense Research Directorate, Ft. Detrick, Maryland, United States of America.
Naval Medical Research Unit-2, Phnom Penh, Cambodia.
PLoS Negl Trop Dis. 2017 Sep 13;11(9):e0005923. doi: 10.1371/journal.pntd.0005923. eCollection 2017 Sep.
Melioidosis is a severe infectious disease caused by the gram-negative soil bacterium Burkholderia pseudomallei. Melioidosis is well known to be a major cause of morbidity and mortality in Southeast Asia, particularly in Thailand. However, melioidosis remains underreported in surrounding areas such as Cambodia. We report a case series of melioidosis in seven patients from Takeo Province, Cambodia. The patients, aged 24-65 years, were enrolled from May 2014 to May 2015 during a one year prospective study of sepsis at Takeo Provincial Hospital. They presented with fever, rigors, dyspnea, fatigue, diaphoresis, productive cough, and skin abscesses. Six of the seven patients were also hyponatremic. B. pseudomallei was cultured from the blood of six patients and the sputum of one patient. In this manuscript, we provide a detailed description of the clinical presentation, case management and laboratory confirmation of B. pseudomallei, as well as discuss the difficulties of identifying and treating melioidosis in low resource settings.
类鼻疽是一种由革兰氏阴性土壤细菌伯克霍尔德菌引起的严重传染病。众所周知，类鼻疽是东南亚地区发病和死亡的主要原因，尤其是在泰国。然而，在柬埔寨等周边地区，类鼻疽的报告仍然不足。我们报告了柬埔寨茶胶省7例类鼻疽病例系列。这些患者年龄在24至65岁之间，于2014年5月至2015年5月期间在茶胶省医院进行的为期一年的败血症前瞻性研究中入组。他们表现出发热、寒战、呼吸困难、疲劳、出汗、咳痰和皮肤脓肿。7名患者中有6名还伴有低钠血症。从6名患者的血液和1名患者的痰液中培养出了伯克霍尔德菌。在本手稿中，我们详细描述了伯克霍尔德菌的临床表现、病例管理和实验室确诊情况，并讨论了在资源匮乏地区识别和治疗类鼻疽的困难。
