Related Experiment Videos
Acute systemic melioidosis: an autopsy study of six cases
1Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Abstract:
Autopsy findings of six cases of the acute systemic melioidosis from Siriraj Hospital, Bangkok, Thailand during the years 1977 to 1986 are presented. Five out of six cases had some underlying conditions. Multiple abscesses and multiple organs involvement were the rule. The organs most commonly involved were lung and liver. Three patients had pericardial and one had adrenal gland involvement. Other significant pathological findings were fibrin thrombi (5/6 cases), haemorrhage (6/6 cases), tissue necrosis (4/6 cases) and granular casts in renal tubules (1/6 case). Abscess alone cannot explain the death of patients. Toxaemia, both exotoxins and endotoxin, is the most likely explanation from the death of patients.
Insights
Autopsy findings reveal acute systemic melioidosis often involves multiple organs, particularly the lungs and liver, in patients with underlying conditions. Toxaemia, caused by bacterial toxins, is the likely cause of death, not just abscesses.
Area of Science:
- Pathology
- Infectious Diseases
- Microbiology
Background:
- Melioidosis is a serious infectious disease caused by Burkholderia pseudomallei.
- Acute systemic melioidosis presents a diagnostic challenge, particularly in endemic regions.
- Understanding autopsy findings is crucial for characterizing the pathology of fatal cases.
Observation:
- Autopsy of six fatal acute systemic melioidosis cases from Thailand (1977-1986) revealed common involvement of lungs and liver.
- Multiple abscesses and organ involvement were characteristic, with five cases having underlying conditions.
- Hemorrhage, fibrin thrombi, and tissue necrosis were significant pathological findings.
Findings:
- The lungs and liver were the most frequently affected organs in systemic melioidosis.
- While abscesses were present, they alone did not fully explain mortality.
- Toxaemia, resulting from bacterial exotoxins and endotoxins, emerged as the most probable cause of death.
Implications:
- These findings underscore the critical role of toxaemia in melioidosis mortality.
- Accurate pathological characterization aids in understanding disease progression and treatment strategies.
- Further research into the mechanisms of toxaemia in melioidosis is warranted for improved patient outcomes.