Mahawerawat K, Kasemsiri P
Department of Otorhinolaryngology,Mukdahan Hospital,Thailand.
Department of Otorhinolaryngology,Srinagarind Hospital, Faculty of Medicine at Khon Kaen University,Thailand.
J Laryngol Otol. 2018 Sep;132(9):827-831. doi: 10.1017/S0022215118001391. Epub 2018 Sep 5.
Although melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.
To report the clinical presentation and management of melioidosis in the head and neck.
A retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.
Medical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35-88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47-98.80).
Careful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.
尽管头颈部类鼻疽并不常见，但它是一种潜在的危及生命的感染。因此，早期诊断和恰当的治疗非常重要。
报告头颈部类鼻疽的临床表现及治疗情况。
于2013年1月1日至2016年10月31日在泰国穆达汉医院开展一项回顾性研究。对培养确诊为类鼻疽的患者的病例记录进行分析。
分析了49例患者（23例男性和26例女性）的病历。患者年龄从1岁至75岁不等。临床表现包括22例腮腺脓肿、16例颈部脓肿和11例化脓性淋巴结炎。只有35例患者（71%）间接血凝试验滴度≥1:160（95%置信区间=45.35 - 88.28）。几乎一半的患者先接受静脉注射头孢他啶治疗，随后口服复方新诺明。轻度局限性类鼻疽采用口服抗生素治疗方案。总体而言，95.65%的患者病情缓解，未观察到复发情况（95%置信区间=85.47 - 98.80）。
需要仔细的临床关联和恰当的检查来早期诊断类鼻疽并启动适当的治疗。
