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类鼻疽所致实体器官脓肿:印度奥里萨邦糖尿病患者中一种新出现的感染

Solid Organ Abscess by Melioidosis: An Emerging Infection Among Diabetics in Odisha, India.

作者信息

Dash Pallabi, Prusty Sandeep Kumar, Pattnaik Sidharth S, Mohapatra Niranjan

机构信息

Internal Medicine, Srirama Chandra Bhanja (SCB) Medical College and Hospital, Cuttack, IND.

出版信息

Cureus. 2022 Dec 26;14(12):e32975. doi: 10.7759/cureus.32975. eCollection 2022 Dec.

Abstract

Melioidosis is an infection in tropical regions, caused by Gram-negative bacillus and carries very high case fatality rates. Diabetes mellitus is a major risk factor for melioidosis, and Odisha with its current trends in urban prevalence of diabetes and a tropical coastal climate seems to be emerging as a hub of melioidosis. We herein describe two cases of melioidosis encountered within a month. Case 1 is a 35-year-old male recently diagnosed with diabetes, presenting with fever and altered sensorium for 5 days. Case 2 is a 40-year-old female who complained of fever, cough, and generalised weakness for 2 months, and was subsequently found to be diabetic on routine investigations. Both the patients were subjected to imaging modalities which showed solid organ (liver and spleen) abscesses. On further investigations, was isolated from their blood cultures. Diagnosis of such cases within a short period of time points to the fact that Odisha indeed serves as a hidden hotspot of melioidosis. The case report throws light on the importance of early diagnosis and treatment of melioidosis, which is under-reported in the state, and it also aims to impress upon physicians to have a strong clinical suspicion so as to decrease the mortality associated this neglected tropical disease.

摘要

类鼻疽是一种发生在热带地区的感染性疾病,由革兰氏阴性杆菌引起,病死率极高。糖尿病是类鼻疽的主要危险因素,奥里萨邦目前糖尿病的城市患病率趋势以及热带沿海气候似乎正使其成为类鼻疽的高发地区。我们在此描述一个月内遇到的两例类鼻疽病例。病例1是一名35岁男性,最近被诊断出患有糖尿病,发热并意识改变5天。病例2是一名40岁女性,主诉发热、咳嗽和全身无力2个月,随后在常规检查中被发现患有糖尿病。两名患者均接受了影像学检查,结果显示实体器官(肝脏和脾脏)有脓肿。进一步检查发现,从他们的血培养物中分离出了[具体病菌未提及]。在短时间内诊断出此类病例表明,奥里萨邦确实是类鼻疽的一个隐藏高发地区。该病例报告揭示了类鼻疽早期诊断和治疗的重要性,该病在该邦报告不足,同时也旨在促使医生产生强烈的临床怀疑,以降低与这种被忽视的热带疾病相关的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a1/9876741/35179b00d42d/cureus-0014-00000032975-i01.jpg

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