Western Australian Radiology Training Program, Royal Perth Hospital, Perth, Western Australia, Australia.
Perth Children's Hospital, Perth, Western Australia, Australia.
J Med Imaging Radiat Oncol. 2024 Sep;68(6):651-658. doi: 10.1111/1754-9485.13729. Epub 2024 Jul 10.
Melioidosis may occasionally be encountered in non-endemic areas and medical imaging is frequently used to identify and characterise sites of disease. The purpose of this study is to describe the spectrum of imaging findings encountered in melioidosis patients treated in the tertiary public hospitals of Perth, Western Australia, between 2002 and 2022.
A database search and electronic medical record review was used to identify cases. Cases were included if they had Burkholderia pseudomallei isolated on culture and if they had at least one diagnostic imaging study performed at a Perth public tertiary hospital. The relevant imaging studies were reviewed, and imaging findings were recorded.
Thirty-six cases were identified. The most common disease manifestation was bacteraemia (72%, 26 cases), followed by pulmonary infection (58%, 21 cases), skin and soft tissue infection (22%, eight cases), prostate abscess (14%, five cases) and septic arthritis (6%, two cases). A previously unreported case of isolated melioid pleural effusion was identified, as was a case of reactivated chronic latent pulmonary melioidosis with an apparent delay of over 20 years between the onset of symptoms and the time of infection. In cases with pulmonary melioidosis, the major lung abnormalities on CT chest could be categorised into one of two distinct patterns: nodular-predominant (78%) or consolidation-predominant (22%).
Further research is required to assess the utility of the pattern-based categorisation of lung abnormalities on CT chest seen in the pulmonary melioidosis cases of this series.
在非流行地区偶尔会遇到类鼻疽病，医学影像学常用于识别和描述疾病部位。本研究旨在描述 2002 年至 2022 年期间在西澳大利亚州珀斯的三级公立医院治疗的类鼻疽病患者的影像学表现谱。
通过数据库搜索和电子病历回顾来确定病例。如果培养分离出伯克霍尔德菌假单胞菌且至少在珀斯的一家公立三级医院进行了一项诊断性影像学检查，则将病例纳入研究。对相关影像学研究进行了回顾，并记录了影像学表现。
确定了 36 例病例。最常见的疾病表现是菌血症（72%，26 例），其次是肺部感染（58%，21 例）、皮肤和软组织感染（22%，8 例）、前列腺脓肿（14%，5 例）和脓毒性关节炎（6%，2 例）。发现了一例先前未报道的孤立性类鼻疽性胸腔积液病例，以及一例慢性潜伏性肺部类鼻疽病再激活病例，其症状发作与感染之间的时间间隔明显超过 20 年。在有肺部类鼻疽病的病例中，胸部 CT 上的主要肺部异常可分为两种截然不同的模式之一：结节为主型（78%）或实变为主型（22%）。
需要进一步研究来评估本系列肺部类鼻疽病病例中 CT 胸部上肺部异常的基于模式的分类的实用性。
