Currie B, Howard D, Nguyen V T, Withnall K, Merianos A
Menzies School of Health Research, Casurina, NT, Australia.
Southeast Asian J Trop Med Public Health. 1993 Sep;24(3):436-43.
From November 1990 to June 1991, 33 cases of acute melioidosis were diagnosed in tropical Northern Territory, Australia during an exceptionally wet monsoon. Eighteen (55%) were alcoholic, 16 (48%) diabetic and only 4 (12%, all survivors) had no risk factors. Twenty-seven (82%) were considered recent infection, with an incubation period of 3-21 days (mean 14) documented in eight cases with presumed cutaneous inoculation. Fourteen patients presented with pneumonia (4 septicemic) and of 11 others with septicemia 4 had genitourinary foci. Three of 4 with splenic abscesses required splenectomy. Three had only skin/soft tissue infection. One patient with brainstem encephalitis needed prolonged ventilation. Overall mortality was 36% (12 cases, including three relapses), despite therapy with ceftazidime and intensive care facilities. Pseudomonas pseudomallei is the commonest diagnosed cause of fatal bacteremic pneumonia at Royal Darwin Hospital and emphasis is placed on early appropriate antibiotic therapy and compliance with maintenance therapy for at least three months.
1990年11月至1991年6月期间，在澳大利亚北领地热带地区一场异常潮湿的季风期间，确诊了33例急性类鼻疽病。18例（55%）为酗酒者，16例（48%）患有糖尿病，只有4例（12%，均存活）无危险因素。27例（82%）被认为是近期感染，8例推测为皮肤接种感染的病例记录了潜伏期为3至21天（平均14天）。14例患者表现为肺炎（4例为败血症型），11例败血症患者中有4例有泌尿生殖系统病灶。4例脾脓肿患者中有3例需要进行脾切除术。3例仅有皮肤/软组织感染。1例脑干脑炎患者需要长时间通气。尽管使用了头孢他啶治疗并设有重症监护设施，但总体死亡率仍为36%（12例，包括3例复发）。在达尔文皇家医院，类鼻疽假单胞菌是诊断出的导致致命菌血症性肺炎的最常见病因，重点是早期进行适当的抗生素治疗并坚持至少三个月的维持治疗。
