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Melioidosis with a subdural collection - a case report

Amarasena, H L P ; Silva, F H D S ; Tilakaratna, P M Y I ; Jayamanne, S F ; Ranawaka, U K

BMC infectious diseases, 2019-02, Vol.19 (1), p.143-143, Article 143 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
Melioidosis with a subdural collection - a case report
Autor: Amarasena, H L P ; Silva, F H D S ; Tilakaratna, P M Y I ; Jayamanne, S F ; Ranawaka, U K
Assuntos: Abdomen ; Abscess ; Abscesses ; Aminoglycosides ; Antibiotics ; Antibodies ; Bacterial infections ; Blood culture ; Blood tests ; Brain ; Burkholderia ; Burkholderia pseudomallei ; Care and treatment ; Case Report ; Case reports ; Case studies ; CAT scans ; Central nervous system ; Collection ; Computed tomography ; Cotrimoxazole ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diagnostic imaging ; Doxycycline ; Epilepsy ; Gentamicin ; Headache ; Hemagglutination ; Illnesses ; Imipenem ; Indirect hemagglutination ; Infection ; Infections ; Infectious diseases ; Inflammation ; Intravenous administration ; Laboratories ; Lesions ; Magnetic resonance imaging ; Melioidosis ; Meropenem ; Morbidity ; Nervous system ; Numbness ; Pseudomonas infections ; Risk factors ; Seizures ; Seizures (Medicine) ; Signs and symptoms ; Sri Lanka ; Subdural collection ; Test procedures ; Tropical environments ; Type 2 diabetes
É parte de: BMC infectious diseases, 2019-02, Vol.19 (1), p.143-143, Article 143
Notas: ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
Descrição: Melioidosis is an infection caused by Burkholderia pseudomallei, which is more prevalent in the tropics and leads to significant morbidity and mortality. It characteristically produces widespread caseous lesions and abscesses, and can present with varied clinical manifestations. Melioidosis involving the central nervous system is uncommon. A 42-year-old Sri Lankan male with type 2 diabetes presented with a febrile illness of 6 days with headache and constitutional symptoms. Clinical examination was unremarkable. Four days later, he developed focal seizures involving the left leg and numbness of the left side. Initial laboratory investigations were suggestive of a bacterial infection. Blood culture was reported as positive for a Pseudomonas species, which was resistant to gentamicin. Contrast enhanced CT and MRI scans of the brain showed a subdural collection in the right fronto-temporo-parietal region with possible abscess formation. Melioidosis antibody testing using indirect hemagglutination method was reactive with a titre more than 1/10,240. He was treated with intravenous meropenem and oral co-trimoxazole for 8 weeks (Intensive phase). The subdural collection was managed conservatively, and seizures were treated with oral antiepileptics. At 7 weeks, follow-up contrast enhanced MRI showed improvement of the subdural collection, and inflammatory markers had normalized. He was discharged after 8 weeks, and treated with oral co-trimoxazole and doxycycline for 6 months (eradication phase). At 6 months follow-up, the patient is asymptomatic. Cerebral melioidosis is an unusual presentation of melioidosis where the diagnosis can be easily missed. Knowledge of the protean manifestations of melioidosis is of paramount importance in order to detect and treat this potentially fatal infection appropriately, especially in tropical countries where the disease is endemic.
Editor: England: BioMed Central Ltd
Idioma: Inglês

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Melioidosis with a subdural collection - a case report

Amarasena, H L P ; Silva, F H D S ; Tilakaratna, P M Y I ; Jayamanne, S F ; Ranawaka, U K

England: BioMed Central Ltd

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