Related Experiment Video
Updated: Sep 14, 2025
Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis
Published on: February 24, 2023
Clinical scoring system to differentiate melioidosis from other documented causes of community-acquired bacterial
Nitin Gupta1,2,3, Chiranjay Mukhopadhyay4, Tirlangi Praveen Kumar5
1Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India. nitin.gupta@manipal.edu.
Background:
Melioidosis, caused by Burkholderia pseudomallei, is an underdiagnosed cause of community-acquired pneumonia (CAP) in India. Due to overlapping features with other bacterial pneumonias and limited access to culture facilities, early diagnosis and treatment remain challenging. This study aimed to develop a clinical scoring system to distinguish melioidosis from other bacterial causes of CAP in an endemic setting.
Methods:
We conducted a retrospective cohort study of 337 patients with radiologically confirmed blood or respiratory culture-positive CAP cases at a tertiary care hospital in South India from 2017 to 2023. This included 55 melioidosis cases and 282 controls with other documented bacterial etiologies. Demographic, clinical, laboratory, and radiological variables were compared. Multivariable logistic regression identified independent predictors of melioidosis. A scoring system was developed using the natural logarithms of adjusted odds ratios (aORs).
Results:
Four independent predictors were retained in the final model: monsoon season exposure (aOR = 9.0, 95% CI: 3.6-22.6), diabetes mellitus (aOR = 10.1, 95% CI: 3.6-28.5), shock at presentation (aOR = 17.2, 95% CI: 5.9-49.9), and extrapulmonary focal involvement (aOR = 36.5, 95% CI: 11.0-121.4). The model showed excellent discrimination. A score of ≥ 4 out of 11 yielded a sensitivity of 87.3% and specificity of 83.6%, while a score of ≥ 5 yielded a sensitivity and specificity of 67.3% and 95.4%, respectively.
Conclusion:
We propose a simple four-point clinical scoring tool to identify melioidosis in patients with CAP. This score can guide early suspicion and appropriate therapy in endemic resource-limited settings. Prospective validation in other endemic regions is warranted.
Insights
A new clinical scoring tool helps identify melioidosis, a serious cause of community-acquired pneumonia (CAP), in India. This simple score aids early diagnosis and treatment in resource-limited settings.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Public Health
Background:
- Melioidosis, caused by Burkholderia pseudomallei, is an underdiagnosed cause of community-acquired pneumonia (CAP) in India.
- Challenges in early diagnosis include overlapping symptoms with other bacterial pneumonias and limited access to culture facilities.
- This study aimed to develop a clinical scoring system to differentiate melioidosis from other bacterial CAP etiologies in endemic areas.
Purpose of the Study:
- To develop and validate a clinical scoring system for early identification of melioidosis in patients with CAP.
- To improve diagnostic accuracy in resource-limited settings where specialized laboratory facilities are scarce.
- To guide timely and appropriate therapeutic interventions for melioidosis.
Main Methods:
- A retrospective cohort study involving 337 patients with culture-positive CAP (55 melioidosis, 282 controls) was conducted in South India (2017-2023).
- Demographic, clinical, laboratory, and radiological data were analyzed.
- Multivariable logistic regression identified independent predictors, and a scoring system was derived from adjusted odds ratios.
Main Results:
- Four independent predictors for melioidosis were identified: monsoon season exposure, diabetes mellitus, shock at presentation, and extrapulmonary focal involvement.
- The developed scoring system demonstrated excellent discrimination.
- A score of ≥4 provided 87.3% sensitivity and 83.6% specificity; a score of ≥5 yielded 67.3% sensitivity and 95.4% specificity.
Conclusions:
- A simple four-point clinical scoring tool is proposed for identifying melioidosis in CAP patients.
- This score can facilitate early suspicion and appropriate treatment in endemic, resource-limited regions.
- Prospective validation in other endemic areas is recommended.
More Related Videos
06:04Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
12:27The Utilization of Oropharyngeal Intratracheal PAMP Administration and Bronchoalveolar Lavage to Evaluate the Host Immune Response in Mice
Published on: April 2, 2014
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...