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Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis
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Bacteraemic melioidosis pneumonia: impact on outcome, clinical and radiological features

Amartya Mukhopadhyay1, Kang Hoe Lee, Paul Ananth Tambyah

  • 1Department of Medicine, Level 3, Main Building, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.

The Journal of Infection
|April 7, 2004
PubMed
Abstract

Insights

Bacteraemic melioidosis pneumonia in Southeast Asia has a high mortality rate, often occurring early. Early and appropriate antibiotic therapy is crucial for treating this condition, as radiological findings are non-specific.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is endemic in Southeast Asia and associated with high mortality, particularly when presenting with bacteraemia.
  • Bacteraemic melioidosis pneumonia is a severe manifestation requiring detailed clinical and radiological characterization.

Purpose of the Study:

  • To describe the clinical and radiological features of bacteraemic melioidosis pneumonia.
  • To compare these features with bacteraemic melioidosis patients without pneumonia.
  • To highlight the mortality rates and implications for clinical management.

Main Methods:

  • Retrospective analysis of patients with positive blood cultures for B. pseudomallei from October 1997 to November 2001.
  • Patients were categorized into 'Pneumonia' and 'Non-pneumonia' groups based on clinical and radiological evidence.
  • Comparison of demographic, clinical, laboratory, and outcome data between the two groups.

Main Results:

  • The pneumonia group (18/30 patients) exhibited higher rates of hyponatraemia, acidosis, diabetes, renal impairment, and ICU admission, with all requiring mechanical ventilation.
  • Mortality was significantly higher in the pneumonia group (72%) compared to the non-pneumonia group (25%).
  • Chest radiographs were non-specific, showing variable lung involvement and pleural effusions; no cavitary disease was observed. Visceral abscesses were common.

Conclusions:

  • Bacteraemic melioidosis with pneumonia is associated with high early mortality.
  • Radiological findings in melioidosis pneumonia are non-specific, underscoring the need for clinical suspicion.
  • Clinicians in Southeast Asia must maintain awareness of melioidosis to ensure prompt and appropriate antibiotic treatment.

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