Koshy Maria, Sadanshiv Prashansa, Sathyendra Sowmya
1 Assistant Professor, Department of Medicine, Christian Medical College, Vellore, India.
2 Post graduate registrar, Department of Medicine, Christian Medical College, Vellore, India.
Trop Doct. 2019 Apr;49(2):104-107. doi: 10.1177/0049475518817416. Epub 2018 Dec 17.
Melioidosis is the disease caused by the soil and water bacterium, Burkholderia pseudomallei. Our study aimed to delineate its genitourinary manifestations. Over a 10-year period (2006-2016), 20 adults with culture-confirmed genitourinary melioidosis were identified. The patients were all men with a mean age of 45.3 ± 12.3 years. The common risk factors were diabetes mellitus (65%) and alcoholism (25%); a majority of patients (90%) had chronic melioidosis. Most had disseminated disease (n = 17) and 55% were bacteraemic. The prostate was the organ most frequently involved (60%, n = 12), followed by the kidney, bladder and seminal vesicles. Diagnosis was established by blood and urine cultures and imaging. Patients were successfully treated with ceftazidime intensive therapy followed by eradicative therapy, with surgical debridement and guided aspiration, when deemed necessary. There was one case fatality and no relapses. Melioidosis is an important differential to be considered in chronic genitourinary infections in the appropriate setting.
类鼻疽是由土壤和水中的细菌——伯克霍尔德菌引起的疾病。我们的研究旨在描述其泌尿生殖系统表现。在10年期间（2006 - 2016年），共确定了20例经培养确诊的泌尿生殖系统类鼻疽成年患者。患者均为男性，平均年龄为45.3±12.3岁。常见的危险因素为糖尿病（65%）和酗酒（25%）；大多数患者（90%）患有慢性类鼻疽。大多数患者有播散性疾病（n = 17），55%的患者有菌血症。前列腺是最常受累的器官（60%，n = 12），其次是肾脏、膀胱和精囊。通过血液和尿液培养及影像学检查确诊。患者接受头孢他啶强化治疗，随后进行根除治疗，必要时进行手术清创和引导性穿刺抽吸，治疗成功。有1例死亡病例，无复发情况。在适当的情况下，类鼻疽是慢性泌尿生殖系统感染中需要考虑的重要鉴别诊断。
