2,994
回編集
差分
ナビゲーションに移動
検索に移動
→clinical course
**a case of 62 years after exposed in Viet Nam
***"Vietnamese time-bomb"
**keep latent in macrophage for long time
***rational of long-term maintenance oral treatment
**where ''Burkholderia''-containing macrophages are kept in human body is still unknown
==risk factors==
*especially diabetes mellitus and chronic renal failure
**steroid, alcohol abuse, liver dysfunction, chronic lung disease, etc.
*HIV never predisposes to melioidosis
==clinical course==
*widespread metastatic abscesses
**liver, spleen, parotid gland, prostate in male, cutaneous, subcutaneous, keratitis
**parotitis/parotid abscess common in children in Thailand**in endemic areas, melioidosis is the commonest cause of children's suppurative parotits*hepatosplenic abscess common in Thailand**prostatic abscess common in Australia
==diagnosis==
==treatment==
#2 weeks intensive parenteral antimicrobial
*ceftazidime or meropenem IV
#12-20 weeks eradicative oral antimicrobial
*co-trimoxazole or co-amoxicluv PO
==prognosis==
*mortality of severe mellioidosis 40% in Thailand, 14% in Australia
**deaths within 48hrs after hospitalization common
**less mortal without underlying condition
*treatment response slow
**mean 9 days fever
*reinfection in 1-3.4% of survivors in long-term followup
