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Clinical presentation and treatment of melioidosis in the head and neck region

Published online by Cambridge University Press:  05 September 2018

K Mahawerawat  and
P Kasemsiri
K Mahawerawat
Affiliation:
Department of Otorhinolaryngology, Mukdahan Hospital, Thailand
P Kasemsiri*
Affiliation:
Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine at Khon Kaen University, Thailand
*
Author for correspondence: Dr Pornthep Kasemsiri, Skull Base Surgery Unit, Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine at Khon Kaen University, Khon Kaen 40002, Thailand E-mail: Pkcolumbus99@gmail.com Fax: +66 43 202 490
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Abstract

Background

Although melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.

Objectives

To report the clinical presentation and management of melioidosis in the head and neck.

Method

A retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.

Results

Medical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35–88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47–98.80).

Conclusion

Careful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.

Keywords

Burkholderia PseudomalleiMelioidosisParotitisLymphadenitis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 827 - 831
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr P Kasemsiri takes responsibility for the integrity of the content of the paper

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