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Neurologic melioidosis

Martin Deuble1, Chloe Aquilina, Robert Norton

  • 1Townsville Hospital, Townsville, Queensland, Australia. mjdeuble@gmail.com

The American Journal of Tropical Medicine and Hygiene
|July 10, 2013
PubMed

Insights

Neurologic melioidosis, caused by Burkholderia pseudomallei, presents with fever, headache, and ataxia in endemic areas. Early diagnosis and awareness are crucial, as it can lead to significant mortality and long-term neurologic sequelae.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Tropical Medicine

Background:

  • Melioidosis is a significant cause of illness and death in Southeast Asia and northern Australia.
  • Burkholderia pseudomallei is the causative agent, diagnosed via clinical specimen culture.
  • Neurologic manifestations of melioidosis can vary widely.

Purpose of the Study:

  • To review cases of confirmed neurologic melioidosis admitted to a regional hospital between 1995 and 2011.
  • To identify clinical features, diagnostic findings, and outcomes of neurologic melioidosis.
  • To emphasize the importance of considering melioidosis in neurologic disease diagnosis in endemic regions.

Main Methods:

  • Retrospective review of hospital admissions for culture-confirmed neurologic melioidosis.
  • Analysis of patient demographics, clinical presentations, diagnostic methods (including cerebrospinal fluid analysis), and neuroimaging findings (MRI T2-weighted scans).
  • Assessment of treatment outcomes, mortality, and long-term neurologic sequelae.

Main Results:

  • Twelve culture-confirmed cases of neurologic melioidosis were identified.
  • Two cases were diagnosed via cerebrospinal fluid analysis.
  • Common symptoms included fever, headache, and ataxia; MRI showed ring-enhancing lesions and leptomeningeal enhancement.
  • Four patients died, and four experienced significant long-term neurologic deficits.

Conclusions:

  • Neurologic melioidosis is a serious condition with high mortality and morbidity in endemic areas.
  • Clinical features like fever, headache, and ataxia, along with specific MRI findings, are characteristic.
  • Increased awareness of neurologic melioidosis is vital for diagnosing undifferentiated neurologic diseases in affected regions.

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