Ling Ting Ting, Lee Su-Yin, Tsao Shih-Ming, Liang Keng-Wei, Wang Wei-Yao
Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Infection Control Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
Front Med (Lausanne). 2023 Apr 6;10:1131788. doi: 10.3389/fmed.2023.1131788. eCollection 2023.
Melioidosis is a systemic and suppurative disease endemic in the Southeast Asia. In Taiwan, most cases are reported in the southern region and no relevant profiles have been reported in central region. In this study, we performed the epidemiologic and clinical analyses from the melioidosis cases in central Taiwan.
The demographic, clinical, laboratory, radiologic, and outcome profiles were collected retrospectively and analyzed from patients whom was isolated from clinical specimens during the 12-year study period (2011-2022).
Totally 11 melioidosis cases (10 males and 1 female) were diagnosed, among them only 2 (18.2%) cases lived in suburban areas. Seven (63.6%) cases were diagnosed during 2019-2020, and diabetes mellitus was the most relevant comorbidity (5, 45.4%). All cases presented with fever at arrival, but only 4 (36.4%) and 2 (18.2%) cases presented with dyspnea and shock, respectively. Pneumonitis and extrapulmonary involvement were found in 5 cases (45.4%) each. Appropriate empiric and targeted antibiotic treatments were found in 4 (36.4%) and 10 (91.0%) case, respectively. Two cases (18.2%) succumbed to infection despite appropriate treatment including targeted antibiotics.
Melioidosis has become endemic in central Taiwan. Septic patients who present with suppurative or undetermined foci and have unsatisfied responses to standard treatment should arouse clinicians to take melioidosis into consideration.
类鼻疽是一种在东南亚流行的全身性化脓性疾病。在台湾，大多数病例报告于南部地区，中部地区尚无相关病例报道。在本研究中，我们对台湾中部的类鼻疽病例进行了流行病学和临床分析。
回顾性收集并分析了在12年研究期间（2011 - 2022年）从临床标本中分离出病原体的患者的人口统计学、临床、实验室、影像学和结局资料。
共诊断出11例类鼻疽病例（10例男性和1例女性），其中仅2例（18.2%）居住在郊区。7例（63.6%）病例在2019 - 2020年被诊断，糖尿病是最相关的合并症（5例，45.4%）。所有病例入院时均有发热，但分别仅有4例（36.4%）和2例（18.2%）出现呼吸困难和休克。肺炎和肺外受累各发现5例（45.4%）。分别有4例（36.4%）和10例（91.0%）病例接受了适当的经验性和针对性抗生素治疗。尽管接受了包括针对性抗生素在内的适当治疗，仍有2例（18.2%）病例死于感染。
类鼻疽在台湾中部已成为地方病。对于出现化脓性或不明病灶且对标准治疗反应不佳的脓毒症患者，临床医生应考虑到类鼻疽。
