scholarly journals Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report

2015 ◽  
Vol 3 (1) ◽  
pp. 59-62
Author(s):  
Hai Sherng Lee ◽  
Abdul Azeez Ahamed Riyaaz ◽  
Seng Hong Yeoh
Keyword(s):  
Septic Arthritis ◽  
Burkholderia Pseudomallei ◽  
Indian Subcontinent ◽  
Systemic Vasculitis ◽  
Abdominal Ultrasound ◽  
Left Knee ◽  
High Grade Fever ◽  
Mortality And Morbidity ◽  
Pulmonary Consolidation ◽  
Disease Case

Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Case: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associated with chills, rigors and night sweats, and a productive cough. Examination revealed active synovitis with effusion involving his left knee, ankle and elbow joints and scattered crackles over both lung fields. Chest X-ray showed diffuse pulmonary consolidation. Abdominal ultrasound showed splenic micro-abscesses. The diagnosis was made based on a positive blood culture for Burkholderia pseudomallei. He was started on appropriate antibiotics and responded well, becoming afebrile after 48 hours, while his joint effusions disappeared after one week. Conclusion: Septic arthritis only occurs in 4% of patients with melioidosis. When there is diffuse pulmonary involvement, melioidosis may mimic disseminated tuberculosis, sepsis syndromes, and systemic vasculitis syndromes. This case is relevant for medical literature as melioidosis is emerging and is expanding its territories worldwide. It should be considered early in the differential diagnoses in endemic areas so that treatment can be started early to reduce its high mortality and morbidity.

scholarly journals A RARE CAUSE OF SEPTIC ARTHRITIS WITH PLEURAL EFFUSION: BURKHOLDERIA PSEUDOMALLEI

2016 ◽  
Vol 10 (1) ◽  
pp. 8
Author(s):  
Dr. Navin Ashok Patil ◽  
Balaji O ◽  
Karthik Rao N ◽  
Manjunath Hande ◽  
Talha Ahmed ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Septic Arthritis ◽  
Burkholderia Pseudomallei ◽  
Indian Subcontinent ◽  
Left Knee ◽  
South East Asia ◽  
Northern Australia ◽  
Fatal Disease ◽  
Severe Morbidity

ABSTRACTMelioidosis is a fatal disease, most prevalent in South-East Asia, Northern Australia, and the Indian subcontinent is caused by Gram-negativesaprophyte Burkholderia pseudomallei. Septic arthritis due to melioidosis is very rare and should be a differential diagnosis in patient presenting withseptic arthritis in endemic areas. It results in severe morbidity. Hence, we report a case of septic arthritis of left knee and hip in a young patient wholater developed pleural effusion caused by B. pseudomallei.Keywords: Septic arthritis, Pleural effusion, Vietnamese bomb. 

scholarly journals Melioidosis: A Rare Cause of Liver Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Peter Franz M. San Martin ◽  
Catherine S. C. Teh ◽  
Ma. Amornetta J. Casupang
Keyword(s):  
Liver Abscess ◽  
Burkholderia Pseudomallei ◽  
Abdominal Ultrasound ◽  
Open Drainage ◽  
High Grade Fever ◽  
Rare Presentation ◽  
Culture Studies ◽  
Moderate Growth ◽  
Male Farmer ◽  
History Of

Case Presentation. This is a case of a 44-year-old male, farmer, known to be diabetic, presenting with two-week history of vague abdominal pain associated with high grade fever. Abdominal CT scan showed localized liver abscess at segment 8 measuring 7.5 × 6.8 × 6.1 cm. Patient subsequently underwent laparoscopic ultrasound guided pigtail insertion for drainage of abscess. Culture studies showed moderate growth ofBurkholderia pseudomalleiin which the patient completed seven days of IV Meropenem. On follow-up after 12 weeks of oral Sulfamethoxazole/Trimethoprim, taken twice a day, the patient remained asymptomatic with no residual findings based on the abdominal ultrasound.Discussion. Diagnosis of melioidosis, a known “great masquerader,” relies heavily on culture studies. Consensus with regard to the management of liver abscess caused byBurkholderia pseudomalleihas not yet been established due to the rarity of cases. Surgical intervention through either a percutaneous or open drainage has shown good outcomes compared to IV antibiotics alone. In Philippines, the possibility of underreporting is highly plausible. This write-up serves not only to report a rare presentation of melioidosis but also to add to the number of cases reported in the country, possibly indicative of disease emergence.

scholarly journals Melioidosis- Report of Two Cases

2020 ◽  
pp. 1-3
Author(s):  
Biswabikash Mohanty ◽  
◽  
Amitav Rath ◽  
Sidharth Sankar Sahoo ◽  
Sudhir Pattnaik ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Septic Shock ◽  
Nervous System ◽  
Southeast Asia ◽  
Burkholderia Pseudomallei ◽  
Indian Subcontinent ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Cerebral Abscess ◽  
Bacteremic Patient

Melioidosis which is caused by burkholderia pseudomallei occurs predominantly in Southeast Asia. Cases are now being reported from india as well. It can present with varying clinical manifestations like pneumonia, septicemia, arthritis, abscess etc. Neurologic meliodiosis, though rare can occur in upto 3-4% cases. Here we present two cases of melioidosis from Indian subcontinent, one involving central nervous system causing cerebral abscess and second one involving multiple splenic and liver abscess with bacteremia. First patient with cerebral abscess was managed with surgical debridement with antibiotics and discharged in a stable condition after 15 days while the bacteremic patient developed septic shock with mutiorgan failure and succumbed to death after 12 days of treatment

scholarly journals Duration of immunity against COVID-19 after vaccination in Indian subcontinent

2022 ◽  
Author(s):  
Apoorva Munigela ◽  
Sasikala M ◽  
Gujjarlapudi Deepika ◽  
Anand V Kulkarni ◽  
Krishna Vemula ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Booster Dose ◽  
Indian Subcontinent ◽  
Neutralizing Antibody ◽  
Health Concern ◽  
Mortality Data ◽  
Optimal Timing ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Antibody Levels

Abstract Coronavirus disease (COVID-19) continues to be a major health concern leading to substantial mortality and morbidity across the world. Vaccination is effective in reducing the severity and associated mortality. Data pertaining to the duration of immunity, antibody waning and the optimal timing of booster dose administration is limited. In this cross-sectional study, we assessed the antibody levels in healthcare workers who were fully vaccinated after obtaining Institutional ethics committee approval and informed consent. Whole blood was collected and enumeration of S1/S2 neutralizing antibody levels was carried out using LIAISON SARS-COV-2 S1/S2 IgG assay. A total of 1636 individuals who were vaccinated with Covaxin or Covishield were included. Of these, 52% were males with a median age of 29 years. Diabetes and Hypertension was noted in 2.32% (38/1636) and 2.87% (47/1636) of the individuals. Spike neutralizing antibodies were below the detectable range (<15 AU/ml) in 6.0% (98/1636) of the individuals. Decline in neutralizing antibody was seen in 30% of the individuals above 40 years of age with comorbidities (diabetes and hypertension) after 6 months. These individuals may be prioritized for a booster dose at 6 months.

Septic arthritis in adults

2013 ◽  
Author(s):  
Laura McGregor ◽  
Monica N. Gupta ◽  
Max Field
Keyword(s):  
Septic Arthritis ◽  
Inflammatory Responses ◽  
Joint Disease ◽  
Medical Emergency ◽  
British Society ◽  
Future Research ◽  
Mortality And Morbidity ◽  
Medical Disorders ◽  
Sources Of Infection ◽  
Joint Prostheses

Septic arthritis (SA) is a medical emergency with mortality of around 15%. Presentation is usually monoarticular but in more than 10% SA affects two or more joints. Symptoms include rapid-onset joint inflammation with systemic inflammatory responses but fever and leucocytosis may be absent at presentation. Treatment according to British Society of Rheumatology/British Orthopaedic Association (BSR/BOA) guidelines should be commenced if there is a suspicion of SA. At-risk patients include those with primary joint disease, previous SA, recent intra-articular surgery, exogenous sources of infection (leg ulceration, respiratory and urinary tract), and immunosupression because of medical disorders, intravenous drug use or therapy including tumour necrosis factor (TNF) inhibitors. Synovial fluid should be examined for organisms and crystals with repeat aspiration as required. Most SA results from haematogenous spread-sources of infection should be sought and blood and appropriate cultures taken prior to antibiotic treatment. Causative organisms include staphylococcus (including meticillin-resistant Staphylococcus aureus, MRSA), streptococcus, and Gram-negative organisms (in elderly patients), but no organism is identified in 43%, often after antibiotic use before diagnosis. Antibiotics should be prescribed according to local protocols, but BSR/BOA guidelines suggest initial intravenous and subsequent oral therapy. Medical treatment may be as effective as surgical in uncomplicated native SA, and can be cost-effective, but orthopaedic advice should be sought if necessary and always in cases of infected joint prostheses. In addition to high mortality, around 40% of survivors following SA develop limitation of joint function. Guidelines provide physicians with treatment advice aiming to limit mortality and morbidity and assist future research.

scholarly journals Duplex TaqMan Hydrolysis Probe-Based Molecular Assay for Simultaneous Detection and Differentiation of Burkholderia pseudomallei and Leptospira spp. DNA

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Mohammad Ridhuan Mohd Ali ◽  
Lee Lih Huey ◽  
Phiaw Chong Foo ◽  
Yuan Xin Goay ◽  
Asmaliza S. Ismail ◽  
...  
Keyword(s):  
Burkholderia Pseudomallei ◽  
Simultaneous Detection ◽  
Qpcr Assay ◽  
Taqman Probe ◽  
Molecular Assay ◽  
Mortality And Morbidity ◽  
Leptospira Spp ◽  
Clinical Consequences ◽  
Reference Strains ◽  
Significant Mortality

Melioidosis and leptospirosis, caused by two different bacteria, Burkholderia pseudomallei and Leptospira spp., are potentially fatal infections that share a very similar spectrum of clinical features and cause significant mortality and morbidity in humans and livestock. Early detection is important for better clinical consequences. To our knowledge, there is no diagnostic tool available to simultaneously detect and differentiate melioidosis and leptospirosis in humans and animals. In this study, we described a duplex TaqMan probe-based qPCR for the detection of B. pseudomallei and Leptospira spp. DNA. The performance of the assay was evaluated on 20 B. pseudomallei isolates, 23 Leptospira strains, and 39 other microorganisms, as well as two sets of serially diluted reference strains. The duplex qPCR assay was able to detect 0.02 pg (~ 4 copies) Leptospira spp. DNA and 0.2 pg (~ 25.6 copies) B. pseudomallei DNA. No undesired amplification was observed in other microorganisms. In conclusion, the duplex qPCR assay was sensitive and specific for the detection of B. pseudomallei & Leptospira spp. DNA and is suitable for further analytical and clinical evaluation.

scholarly journals Septicaemic Melioidosis Complicated by Septic Arthritis in A Bangladeshi male: A Case Report

2018 ◽  
Vol 29 (2) ◽  
pp. 94-96
Author(s):  
Hasna Fahmima Haque ◽  
Suchismita Debnath ◽  
Samira Rahat Afroze ◽  
Farhana Afroz ◽  
Muhammad Abdur Rahim ◽  
...  
Keyword(s):  
Case Report ◽  
Synovial Fluid ◽  
Septic Arthritis ◽  
Burkholderia Pseudomallei ◽  
Clinical Suspicion ◽  
High Index ◽  
Uncommon Disease ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Melioidosis is an uncommon disease in Bangladesh but in recent years increasing numbers of cases are being diagnosed. A case of septicaemic melioidosis occurring in a young Bangladeshi returning worker is reported here. The patient presented with fever and features of septic arthritis. Diagnostic work-up revealed the growth of Burkholderia pseudomallei from blood and synovial fluid cultures. This case highlights the importance of high index of clinical suspicion for melioidosis in appropriate clinical scenario.Bangladesh J Medicine Jul 2018; 29(2) : 94-96

scholarly journals Methylprednisolone as an alternative therapy for Kawasaki disease: case series

2020 ◽  
Vol 60 (5) ◽  
pp. 283-6
Author(s):  
Yudha Fadhol Arafah ◽  
Sasmito Nugroho ◽  
Noormanto Noormanto ◽  
Nadya Arafuri ◽  
Indah Kartika Murni
Keyword(s):  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
Alternative Therapy ◽  
Case Series ◽  
Cervical Lymphadenopathy ◽  
Conjunctival Hyperemia ◽  
Disease Case ◽  
The Usa ◽  
Acquired Heart Disease ◽  
The Uk

Kawasaki disease (KD), or mucocutaneous syndrome, is an acute, systemic vasculitis of small- and medium-sized arteries that predominantly affects patients younger than five years.1  KD is the leading cause of childhood acquired heart disease in the developed world.2 The incidence in those aged under 5 years varies widely throughout the world, accounting for 8.4 per 100,000 in the UK, 17.5 to 20.8 per 100,000 in the USA, and 239.6 per 100,000 in Japan.2 The diagnosis of classic KD is based on the simultaneous presence of high fever for 5 or more days with at least four of five other symptoms (bilateral conjunctival hyperemia, ulcerations of the lips and inflammation of the oral cavity, polymorphous rash, edema and desquamation of the extremities, and cervical lymphadenopathy), or fever associated with less than 4 of the diagnostic criteria and echocardiographic abnormalities of the coronary arteries.3

scholarly journals Diffuse-Type Tenosynovial Giant Cell Tumor of the Knee with Concurrent Polymicrobial Infection (Klebsiella oxytoca and Group B Streptococcus)

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
J. Hunter Marshall ◽  
John G. Skedros ◽  
Chris F. Campana ◽  
Allan M. Seibert
Keyword(s):  
Septic Arthritis ◽  
Giant Cell ◽  
Klebsiella Oxytoca ◽  
Group B Streptococcus ◽  
Pigmented Villonodular Synovitis ◽  
Acute Onset ◽  
Left Knee ◽  
Diffuse Type ◽  
Giant Cell Tumors ◽  
Group B

Tenosynovial giant cell tumors (TGCT) are a rare class of benign proliferative tumors that are classified according to their presentation: localized-type (L-TGCT) or diffuse-type (D-TGCT). TGCT is synonymous with pigmented villonodular synovitis (PVNS). We describe the unique case of a 56-year-old obese male with type 2 diabetes who had polymicrobial septic arthritis of his left knee joint with concurrent D-TGCT in the same knee. While on a vacation, he noticed spontaneous left knee pain and swelling with an acute onset of fever. He was diagnosed with septic arthritis that was attributed to hematogenous spread from a leg laceration. The septic arthritis was treated with arthroscopic lavage and debridement, including simultaneous excision of the D-TGCT lesions, followed by intravenous ceftriaxone. Cultures of the synovial tissue that were obtained during arthroscopy grew Klebsiella oxytoca and beta-hemolytic (group B) Streptococcus agalactiae. We were not able to find another reported case of any joint with (1) a polymicrobial bacterial infection that included Klebsiella oxytoca and (2) concurrent bacterial septic arthritis and TGCT.

scholarly journals An Unusual Case of IgA Vasculitis with Multisystemic Involvement

2021 ◽  
Author(s):  
Lina Du ◽  
Chang Liu ◽  
Panpan Wang ◽  
Shaojing Li ◽  
Shuang Yue ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Leukocytoclastic Vasculitis ◽  
Immunoglobulin A ◽  
Clinical Signs ◽  
Pulmonary Hemorrhage ◽  
Abdominal Ultrasound ◽  
Pulse Therapy ◽  
Subcortical White Matter ◽  
High Signal ◽  
Disease Case

Abstract Background: Immunoglobulin A vasculitis (IgAV) is one of the most common vasculitis in children. It is generally a self-limiting disease. Due to its systemic nature, a variety of symptoms in different organs can be observed. We report a case of IgAV characterized by several complications to improve clinicians’ understanding of the disease. Case presentation: A 4-year-old boy was admitted to a local hospital because of abdominal pain and skin rash. The skin biopsy showed leukocytoclastic vasculitis with IgA deposition, consistented with a diagnosis of IgAV. He developed clinical signs of intussusception and laparotomy was undertaken. He continued to have intermittent abdominal pain and edema in the four limbs with oliguria. Elevated pancreatic enzymes and swelling of the pancreas on abdominal ultrasound suggested a combination of pancreatitis in the child. The child subsequently developed headache, dizziness and convulsions, and head MRI showed a high signal on the left side of the cortex and subcortical white matter, and he was considered to have developed cerebral vasculitis.He underwent bronchoscopy because of respiratory distress, which which confirmed the presence of pulmonary hemorrhage. Combined pulmonary infections added to the severity and complexity of his condition. He received two courses of methylprednisolone pulse therapy combined with IVIG and aggressive anti-infective therapy, but his condition eventually deteriorated and he died. Conclusions: IgAV can involve multiple systems and various complications. There is no definitive evidence to support a single drug or multi- immunosuppressive regimen. IgAV usually runs a benign course,however, the severe cases are critical, with a high mortality rate.

Sign in / Sign up

Export Citation Format

Share Document