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类鼻疽——东南亚一种未得到充分认识的可怕疾病。

Melioidosis - An under-recognized dreaded disease in Southeast Asia.

作者信息

Muthanikkatt Anas Mohammed, Nathan Balamurugan, Uthayakumar Amaravathi, Devendiran Anandhi, Muthu Saravanan

机构信息

Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Turk J Emerg Med. 2025 Jan 2;25(1):63-66. doi: 10.4103/tjem.tjem_62_24. eCollection 2025 Jan-Mar.

Abstract

Melioidosis is a disease endemic to India but often goes unrecognized, leading to considerable illness and death. We present the case of a 31-year-old man who had a fever of unknown origin, abnormal renal and liver function tests, and negative tests for dengue, typhoid, leptospirosis, and scrub typhus. Imaging revealed multiple splenic infarcts. Initially suspected to be malaria due to its prevalence in South India, further investigation uncovered pneumonia along with several liver and splenic abscesses, raising the possibility of melioidosis. Blood culture eventually identified , confirming the diagnosis. As malaria cases decline in Southeast Asia, emergency physicians should consider melioidosis in their differential diagnosis of acute febrile illnesses, especially in endemic areas. Early detection and prompt antibiotic treatment are vital for managing this often under-recognized disease with a high fatality rate. Thus, melioidosis should be considered in patients with unexplained fever in endemic regions, as early diagnosis and intervention can be life-saving.

摘要

类鼻疽是一种在印度流行的疾病,但常常未被识别,导致相当多的疾病和死亡。我们报告一例31岁男性病例,该患者有不明原因发热、肾功能和肝功能检查异常,登革热、伤寒、钩端螺旋体病和恙虫病检测均为阴性。影像学检查显示多处脾梗死。由于疟疾在印度南部流行,最初怀疑为疟疾,但进一步检查发现了肺炎以及多个肝脾脓肿,增加了类鼻疽的可能性。血培养最终确诊,证实了诊断。随着东南亚疟疾病例的减少,急诊医生在对急性发热性疾病进行鉴别诊断时应考虑类鼻疽,尤其是在流行地区。早期发现和及时使用抗生素治疗对于管理这种常常未被认识且死亡率高的疾病至关重要。因此,在流行地区不明原因发热的患者中应考虑类鼻疽,因为早期诊断和干预可能挽救生命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb05/11774432/f93de281cdd9/TJEM-25-63-g001.jpg

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