Bhat Vaibhav, Gosavi Siddharth, Krishnan Gokul, Acharya Raviraja V
Internal Medicine, Kasturba Medical College of Manipal, Manipal, IND.
Cureus. 2023 Jun 9;15(6):e40182. doi: 10.7759/cureus.40182. eCollection 2023 Jun.
Melioidosis is caused by a Gram-negative, facultative intracellular bacterium. Because melioidosis can mimic many diseases, it requires more advanced laboratory facilities with the necessary expertise and can become an underdiagnosed yet serious infection with high mortality and morbidityOur patient is a middle-aged male with new-onset uncontrolled type 2 diabetes mellitus who presented with high-grade fever, productive cough and altered mental status. CT thorax showed diffuse middle and lower zone consolidation while MRI brain noted meningitis with cerebritis. Blood culture grew. The patient was started on meropenem for melioidosis, however, no adequate improvement was seen. In view of this inadequate response, parenteral cotrimoxazole was added. Significant improvement was noted and cotrimoxazole was continued for six months.
类鼻疽病由革兰氏阴性兼性胞内细菌引起。由于类鼻疽病可模仿多种疾病,它需要更先进的实验室设施以及具备必要专业知识的人员,并且可能成为一种诊断不足但严重的感染,具有高死亡率和发病率。我们的患者是一名中年男性,患有新发且未得到控制的2型糖尿病,出现高热、咳痰和精神状态改变。胸部CT显示中、下肺野弥漫性实变,而脑部MRI提示脑膜炎合并脑炎。血培养有细菌生长。患者开始使用美罗培南治疗类鼻疽病,但未见充分改善。鉴于反应不佳,加用了胃肠外复方新诺明。患者有显著改善,复方新诺明持续使用了6个月。