Dhiensiri T, Eua-Ananta Y
Department of Radiology, Khon Kaen Hospital, Thailand.
J Med Assoc Thai. 1995 May;78(5):225-31.
A retrospective analysis was done in 81 patients with visceral abscess due to melioidosis treated at Khon Kaen Hospital, northeastern Thailand from 1985 to 1993. The clinical presentations were fever 100 per cent, abdominal pain 39 per cent, cough 34.8 per cent, abdominal tenderness 27.5 per cent and palpable mass 24.6 per cent. The laboratory findings were not diagnostic of the etiology. The abscesses were detected by ultrasonography in 97.25 per cent and computed tomography 2.25 per cent. The lesions were found in the spleen 72.8 per cent, liver 45.7 per cent, kidney 12.3 per cent and prostate gland 2.5 per cent. Seventy-six per cent of the patients had diseases in multiple organs (viscera, lungs and others). The preliminary diagnoses were fever of unknown origin, septicemia and urinary tract diseases in one-half of the cases. Patients presenting with fever of unknown origin from an endemic area, like northeastern Thailand, should arouse suspicion of melioidosis and search for the organism is advised. Diagnostic imaging methods, ultrasonography and computed tomography are valuable tools for detection of a solid internal organ abscess.
对1985年至1993年在泰国东北部孔敬医院接受治疗的81例类鼻疽所致内脏脓肿患者进行了回顾性分析。临床表现为发热100%、腹痛39%、咳嗽34.8%、腹部压痛27.5%和可触及肿块24.6%。实验室检查结果无法诊断病因。97.25%的脓肿通过超声检查发现，2.25%通过计算机断层扫描发现。病变见于脾脏72.8%、肝脏45.7%、肾脏12.3%和前列腺2.5%。76%的患者有多个器官（内脏、肺和其他器官）患病。一半病例的初步诊断为不明原因发热、败血症和泌尿系统疾病。来自泰国东北部等流行地区的不明原因发热患者应引起对类鼻疽的怀疑，建议寻找病原体。诊断性成像方法，超声检查和计算机断层扫描是检测实性内脏器官脓肿的有价值工具。
