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Published on: February 24, 2023

Acute melioid community-acquired pneumonia

Chia-Te Kung1, Chao-Jui Li, Shin-Chiang Hung

  • 1Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|June 24, 2011
PubMed
Abstract

Insights

Patients with community-acquired pneumonia (CAP) presenting to the emergency department (ED) during the rainy season, with poor glycemic control (≥250mg/dl), or in shock, face higher risks of melioidosis. Early antibiotics covering Burkholderia pseudomallei are crucial in endemic areas.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is an emerging cause of community-acquired pneumonia (CAP), particularly in tropical regions.
  • Understanding the distinct clinical characteristics and risk factors of melioid CAP is essential for early diagnosis and treatment.

Purpose of the Study:

  • To delineate the patient characteristics and identify risk factors associated with acute melioid CAP upon emergency department (ED) arrival.
  • To differentiate these factors from those observed in severe CAP of non-melioid etiology.

Main Methods:

  • A retrospective case-control study was conducted.
  • 15 patients with acute melioid CAP were compared to 60 patients with severe CAP from other causes.

Main Results:

  • Acute melioid CAP patients were more likely to present during the rainy season, exhibit shock, have diabetes with poor glycemic control (≥250mg/dl), show cavities on chest X-ray, and have poorer outcomes.
  • Independent risk factors for melioid CAP included poor glycemic control (OR 38.3), rainy season ED visits (OR 13.7), and shock on arrival (OR 18.7).

Conclusions:

  • Physicians in endemic areas should consider Burkholderia pseudomallei in CAP patients presenting with specific risk factors.
  • Empirical antimicrobial therapy covering B. pseudomallei is recommended for patients with CAP who visit the ED during the rainy season, have poor glycemic control, or present in shock.
  • Timely and appropriate antibiotic administration can potentially lower mortality rates associated with melioid CAP.

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