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First report of septicaemic melioidosis in Hong Kong
Abstract:
Septicaemia due to Pseudomonas pseudomallei was found in five patients; it complicated pneumonia in three. Four patients were old and had diabetes mellitus; the fifth patient, though young, was immunocompromised by steroid therapy. The clinical features were indistinguishable from those of other Gram-negative septicaemia. Four of the patients died. This was the first report of septicaemic melioidosis in Hong Kong where the disease might be endemic. Soil sampling and serological survey gave further supporting evidence. Early treatment using a bactericidal anti-Pseudomonal cephalosporin, such as ceftazidime, was suggested for this life-threatening infection.
Insights
Melioidosis, a severe infection caused by Pseudomonas pseudomallei, led to fatal septicaemia in four of five patients in Hong Kong. Early ceftazidime treatment is recommended for this potentially endemic disease.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Melioidosis, caused by Pseudomonas pseudomallei, is a serious bacterial infection.
- Septicaemia (blood infection) is a severe manifestation of melioidosis.
- The disease may be endemic in certain regions, including Hong Kong.
Purpose of the Study:
- To report the first cases of septicaemic melioidosis in Hong Kong.
- To highlight the clinical presentation and outcomes of this infection.
- To provide evidence for the endemicity of melioidosis in the region.
Main Methods:
- Clinical case review of five patients with Pseudomonas pseudomallei septicaemia.
- Analysis of patient demographics, clinical features, and treatment outcomes.
- Soil sampling and serological surveys to assess environmental presence and population immunity.
Main Results:
- Five patients developed Pseudomonas pseudomallei septicaemia; three had concurrent pneumonia.
- Four patients died, indicating high mortality.
- Risk factors included advanced age, diabetes mellitus, and immunosuppression (steroid therapy).
- Clinical presentation mimicked other Gram-negative septicaemia.
- Soil and serological data supported endemicity in Hong Kong.
Conclusions:
- Septicaemic melioidosis is a life-threatening condition with high mortality.
- Early diagnosis and prompt treatment with bactericidal anti-Pseudomonal cephalosporins, like ceftazidime, are crucial.
- Melioidosis may be an under-recognized endemic disease in Hong Kong, necessitating further investigation and awareness.