Non-bacteremia liver abscess caused by Burkholderia pseudomallei from a tertiary teaching hospital in Malaysia: a case report and literature review.

Tropical biomedicine Pub Date : 2023-09-01 DOI:10.47665/tb.40.3.003

A A Wahab, S M A Nurazizah, C H Ding, N A S Muttaqillah, A S Nordashima, N Kori, P Periyasamy

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Abstract

Melioidosis is endemic in Southeast Asia, including Malaysia. Liver abscess is not uncommon in melioidosis, but it is usually associated with bacteremia. We presented a case of a 55-year-old gentleman with underlying end-stage renal failure who presented with non-specific abdominal pain for three months. Initial blood investigations showed leukocytosis and increased C-reactive protein. Computed tomography (CT) of the abdomen revealed multiple hypodense lesions in the liver and spleen. The culture of the liver specimen obtained through the ultrasound-guided isolated Burkholderia pseudomallei. He was given an adjusted dose of intravenous ceftazidime due to underlying renal failure. Melioidosis serology also returned positive for IgM with titer >1:1280. His blood cultures were reported negative three times. Despite on antibiotics for five weeks, there was no significant improvement of the liver abscesses was observed. He was unfortunately infected with the SARS-CoV-2 virus during his admission and passed away due to severe COVID-19 pneumonia.

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马来西亚一家三级教学医院由假踝伯克霍尔德菌引起的非菌血症性肝脓肿：病例报告和文献复习。

Melioidosis是东南亚的地方病，包括马来西亚。肝脓肿在类鼻疽中并不罕见，但通常与菌血症有关。我们报告了一例55岁的男性患者，他患有潜在的终末期肾衰竭，并伴有非特异性腹痛，持续了三个月。初步血液检查显示白细胞增多和C反应蛋白升高。腹部计算机断层扫描（CT）显示肝脏和脾脏有多处低密度病变。通过超声引导分离的假踝伯克霍尔德菌获得的肝脏标本的培养。由于潜在的肾功能衰竭，他接受了调整剂量的静脉注射头孢他啶。Melioidosis血清学检测IgM也呈阳性，滴度>1:1280。他的血液培养三次呈阴性。尽管服用了五周的抗生素，但没有观察到肝脓肿的显著改善。不幸的是，他在入院期间感染了SARS-CoV-2病毒，并因严重的新冠肺炎肺炎去世。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Tropical biomedicine

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