Melioidosis in systemic lupus erythematosus: the importance of early diagnosis and treatment in patients from endemic areas
Identifieur interne : 002355 ( Main/Exploration ); précédent : 002354; suivant : 002356Melioidosis in systemic lupus erythematosus: the importance of early diagnosis and treatment in patients from endemic areas
Auteurs : H. Badsha ; C J Edwards ; H H Chng [Singapour]Source :
- Lupus [ 0961-2033 ] ; 2001-11.
English descriptors
- Teeft :
- Acute fulminant pneumonia, Antibiotic, Appropriate antibiotics, Bacterium burkholderia pseudomallei, Blood cultures, Blood glucose, Burkholderia, Burkholderia pseudomallei, Ceftazidime, Chaowagul, Corticosteroid, Dose prednisolone, Doxycycline, Early diagnosis, Endemic, Endemic areas, Erythematosus, Glucose, Immunosuppressed, Immunosuppressed patients, Intravenous, Intravenous ceftazidime, Laboratory diagnosis, Lupus, Melioidosis, Normal creatinine, Northern australia, Prednisolone, Pseudomallei, Pulmonary melioidosis, Relapse, Renal, Renal disease, Risk factors, Severe melioidosis, Singapore, Successful treatment, Systemic lupus erythematosus, Tock seng hospital.
Abstract
Serious infection is a common problem in immunosuppressed patients with systemic lupus erythematosus (SLE). Melioidosis is caused by the Gram-negative bacterium Burkholderia pseudomallei and may present as an acute fulminant pneumonia or septicaemia that is often fatal. The organism is endemic in much of South-east Asia but is being increasingly reported from other parts of the world, including India, Northern Australia and North and South America. In addition to occurring in people who come into contact with contaminated soil or water in endemic areas, the infection is more common in immunosuppressed patients and must be recognised early and treated with appropriate antibiotics. Importantly, it can activate many years after the initial exposure, causing diagnostic confusion. We present the cases of three patients with SLE who were admitted with fever and in whom Burkholderia pseudomallei was isolated from blood cultures. Following treatment with intravenous ceftazidime all patients made a good recovery. These cases demonstrate the importance of considering this infectious organism in patients from endemic areas with unexplained fever. They also illustrate how successful outcomes can be achieved in a frequently fatal disease if an early diagnosis is made and appropriate antibiotics are started promptly.
Url:
DOI: 10.1177/096120330101001111
Affiliations:
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Melioidosis is caused by the Gram-negative bacterium Burkholderia pseudomallei and may present as an acute fulminant pneumonia or septicaemia that is often fatal. The organism is endemic in much of South-east Asia but is being increasingly reported from other parts of the world, including India, Northern Australia and North and South America. In addition to occurring in people who come into contact with contaminated soil or water in endemic areas, the infection is more common in immunosuppressed patients and must be recognised early and treated with appropriate antibiotics. Importantly, it can activate many years after the initial exposure, causing diagnostic confusion. We present the cases of three patients with SLE who were admitted with fever and in whom Burkholderia pseudomallei was isolated from blood cultures. Following treatment with intravenous ceftazidime all patients made a good recovery. These cases demonstrate the importance of considering this infectious organism in patients from endemic areas with unexplained fever. They also illustrate how successful outcomes can be achieved in a frequently fatal disease if an early diagnosis is made and appropriate antibiotics are started promptly.</div></front></TEI><affiliations><list><country><li>Singapour</li></country></list><tree><noCountry><name sortKey="Badsha, H" sort="Badsha, H" uniqKey="Badsha H" first="H" last="Badsha">H. Badsha</name><name sortKey="Edwards, C J" sort="Edwards, C J" uniqKey="Edwards C" first="C J" last="Edwards">C J Edwards</name></noCountry><country name="Singapour"><noRegion><name sortKey="Chng, H H" sort="Chng, H H" uniqKey="Chng H" first="H H" last="Chng">H H Chng</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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