Melioidosis: A new emerging infection in West Coastal Maharashtra

Preetham Napa, S. Lokapure, Ajit Kulkarni, Ajay Keni, Amol Kulkarni, Sanjay Ram Deshpande, Kaustubh Machnurkar, Gopal Wasgaonkar
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Abstract

Melioidosis is a zoonotic infectious disease caused by a gram-negative bacterium . It is an endemic disease in Southeast Asia and Northern Australia, but under reported from India. This study was conducted to determine the geographical epidemiology, risk factors, clinical presentations associated with melioidosis. It is retrospective study of six culture proven cases of Melioidosis from a tertiary care hospital. The six cases of melioidosis were from same geographical location from western coast of Maharashtra. The age group ranged from 3 years to 55 years but more predominant group was within 30-to-50-years. All were males (100%), no female patient was affected. Majority of cases were presented to the hospital in rainy season, from June to September, coincides with season of heavy rainfall. Alcoholism (83.33%) and diabetes mellitus (66.66%) were major risk factors involved. Fever (100%) was most common presenting symptoms. The organ space abscess (50%) involving lymph node, liver and spleen were common followed by disseminated disease and pulmonary melioidosis. All patients were treated with ß-lactam antibiotics as intensive therapy followed by oral cotrimoxazole as eradication therapy. Melioidosis is an emerging infection in India specially in the coastal region with very heavy rainfalls. Male gender is prone to develop the infection with diabetes and alcoholism are additional risk factors. The clinical presentation may vary from localised organ space abscess to septic shock with high mortality. The accurate diagnosis and prompt treatment play key role in managing melioidosis.
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Melioidosis:马哈拉施特拉邦西部沿海地区新出现的一种传染病
Melioidosis 是一种由革兰氏阴性菌引起的人畜共患传染病。它是东南亚和澳大利亚北部的一种地方病,但在印度却鲜有报道。本研究旨在确定瓜虫病的地理分布、风险因素和临床表现。这是一项回顾性研究,研究对象是一家三级医院的六例经培养证实的类鼻疽病例。这六例美拉德氏病病例来自马哈拉施特拉邦西海岸的同一地区。病例年龄从 3 岁到 55 岁不等,但主要集中在 30 至 50 岁之间。所有患者均为男性(100%),没有女性患者。大多数病例都是在雨季(6 月至 9 月,恰逢暴雨季节)来医院就诊的。酗酒(83.33%)和糖尿病(66.66%)是主要的危险因素。发热(100%)是最常见的症状。涉及淋巴结、肝脏和脾脏的器官间隙脓肿(50%)很常见,其次是播散性疾病和肺髓鞘炎。所有患者都接受了ß-内酰胺类抗生素强化治疗,随后口服复方新诺明作为根除疗法。瓜虫病在印度是一种新出现的传染病,尤其是在雨量非常大的沿海地区。男性容易感染,糖尿病和酗酒是额外的风险因素。临床表现多种多样,从局部器官间隙脓肿到脓毒性休克,死亡率都很高。准确的诊断和及时的治疗在控制类鼻疽中起着关键作用。
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