Khatod Yash, Ramankutty Neetha Thayil, Kumar Deepak, Tak Vibhor, Gupta Neha, Rajagopal Rengarajan, Saxena Suvinay
Department of Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, India.
Department of Clinical Microbiology, All India Institute of Medical Sciences, Jodhpur, India.
IDCases. 2024 Jul 30;37:e02040. doi: 10.1016/j.idcr.2024.e02040. eCollection 2024.
Melioidosis is one of the emerging infections in India and is often neglected due to lack of awareness among clinicians. The diseases usually present as multifocal or focal abscesses with bacteremia, yet the isolated septic monoarthritic complicated with septic venous thrombosis is a rare presentation.
This case report describes a 48-year-old male business executive with diabetes and alcoholism who developed septic arthritis caused by and no clear history of exposure to the organism. The patient initially experienced fever, chills, fatigue, reduced urine output, and signs of early sepsis. Despite initial improvement with fluid therapy and antibiotics, the patient's fever persisted. Meticulous clinical examination revealed signs of inflammation and movement restriction in the left shoulder which letter on became obvious and the main complaints of patient. Blood cultures confirmed the presence of . Imaging showed septic arthritis, osteomyelitis, lymphadenitis, and venous thrombosis in the left shoulder. Surgical debridement was performed, and the tissue cultures showed the growth of the same pathogen. This led to significant clinical improvement and with prolonged course of antibiotics, complete resolution of symptoms and normal joint function was achieved.
This case report serves to highlight the rare and atypical presentation of Melioidosis and the importance of suspecting this infection in nonendemic regions underscoring the probable impact of climate change. Early diagnosis, effective source control measures and prolonged antibiotic therapy, emerges as pivotal factors contributing to favorable outcomes in such cases.
类鼻疽是印度新出现的感染性疾病之一，由于临床医生认识不足，该病常被忽视。该疾病通常表现为多灶性或局灶性脓肿并伴有菌血症，然而，孤立的化脓性单关节炎合并化脓性静脉血栓形成是一种罕见的表现。
本病例报告描述了一名48岁患有糖尿病和酗酒的男性企业高管，他患上了由[具体病菌名称未给出]引起的化脓性关节炎，且没有明确的该病菌接触史。患者最初出现发热、寒战、疲劳、尿量减少以及早期脓毒症迹象。尽管通过液体疗法和抗生素治疗初期有所改善，但患者仍持续发热。细致的临床检查发现左肩有炎症和活动受限迹象，随后这些症状变得明显，成为患者的主要诉求。血培养证实存在[具体病菌名称未给出]。影像学检查显示左肩有化脓性关节炎、骨髓炎、淋巴结炎和静脉血栓形成。进行了手术清创，组织培养显示生长出相同的病原体。这导致临床症状显著改善，通过延长抗生素疗程，症状完全缓解，关节功能恢复正常。
本病例报告旨在强调类鼻疽罕见且非典型的表现，以及在非流行地区怀疑这种感染的重要性，突显了气候变化可能产生的影响。早期诊断、有效的源头控制措施和延长抗生素治疗，是这类病例取得良好预后的关键因素。
