Halim Isra, Kokkayil Prathyusha, Kirti Ravi, Priyadarshi Rajeev Nayan, Sarfraz Asim, Pati Binod Kumar, Thakuria Bhaskar
Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Patna, India.
Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Patna, India.
Access Microbiol. 2021 Sep 14;3(9):000260. doi: 10.1099/acmi.0.000260. eCollection 2021.
Melioidosis, a disease with protean clinical manifestations, is prevalent in many parts of India, with established endemic hotspots on the southern coast of the country. However, it is still underdiagnosed in many resource-poor regions of the country. We report what is, to the best of our knowledge, the first case of melioidosis diagnosed and treated in Bihar, an economically underdeveloped state in East India. The patient, a 52-year-old diabetic male, presented to the outpatient department with a fever of insidious onset along with pain and restriction of movement in the right shoulder joint and right knee joint, and swelling and tenderness of bilateral ankle joints. Radiological features were suggestive of multiple joint and organ abscesses. A diagnosis of disseminated septicaemic melioidosis was confirmed microbiologically. The patient improved clinically following aggressive treatment with meropenem and cotrimoxazole. The case highlights the need for increased clinical suspicion of melioidosis and adequate diagnostic facilities, as well as the need for early institution of appropriate empirical antibiotics in suspected cases of melioidosis in this region of the world.
类鼻疽病临床表现多样，在印度许多地区流行，该国南部海岸有已确定的地方性热点地区。然而，在该国许多资源匮乏地区，该病仍未得到充分诊断。据我们所知，我们报告了印度东部经济欠发达的比哈尔邦首例诊断和治疗的类鼻疽病病例。患者为一名52岁的糖尿病男性，因隐匿性发热、右肩关节和右膝关节疼痛及活动受限、双侧踝关节肿胀和压痛就诊于门诊。影像学特征提示多关节和器官脓肿。微生物学检查确诊为播散性败血症型类鼻疽病。患者在接受美罗培南和复方新诺明积极治疗后临床症状改善。该病例凸显了在世界该地区疑似类鼻疽病病例中，需要提高对类鼻疽病的临床怀疑度和具备足够的诊断设施，以及早期使用适当经验性抗生素的必要性。
