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Clinical manifestations of melioidosis in children
1Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Thailand.
Insights
Melioidosis in children can be severe, especially with septicemia, leading to high fatality rates. Localized infections, like suppurative parotitis, are less dangerous, with no deaths observed in this study.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Epidemiology
Background:
- Melioidosis, caused by Burkholderia pseudomallei, is an emerging infectious disease.
- It presents with diverse clinical manifestations, ranging from localized infections to life-threatening septicemia.
- Data on pediatric melioidosis, particularly in specific geographic regions, remains crucial for understanding disease burden and outcomes.
Purpose of the Study:
- To retrospectively review cases of culture-proven melioidosis in children treated at a tertiary care hospital.
- To compare the clinical characteristics, outcomes, and risk factors between septicemic and localized melioidosis.
- To identify common manifestations and mortality rates associated with different forms of pediatric melioidosis.
Main Methods:
- Retrospective chart review of 55 children diagnosed with culture-proven melioidosis between 1979 and 1993.
- Categorization of patients into septicemic (n=20) and localized infection (n=35) groups.
- Analysis of demographic data, clinical presentation, organ involvement, presence of underlying diseases, treatment, and outcomes (shock, mortality).
Main Results:
- Septicemic melioidosis occurred in 20 children, with 55% having underlying diseases and frequent lung involvement (75%).
- The septicemic group experienced high rates of shock (45%) and a case fatality rate of 60%.
- Localized melioidosis, primarily presenting as suppurative parotitis (40%), skin abscesses, and lymphadenitis, had no associated shock or mortality.
Conclusions:
- Pediatric melioidosis with septicemia is a severe condition associated with significant morbidity and high mortality, often linked to underlying health issues.
- Localized melioidosis in children is generally less severe, with suppurative parotitis being a common and non-fatal manifestation.
- Effective management strategies and early diagnosis are critical for improving outcomes in children with melioidosis, especially in endemic areas.
Abstract:
Fifty-five children with culture-proved melioidosis treated at Srinagarind Hospital from 1979 to 1993 were retrospectively reviewed. Twenty patients had septicemia and 35 patients had localized infection. Eleven patients (55%) in the septicemic group had underlying diseases but none in the localized infection group. In the septicemic patients the most common organ involvement was the lung (75%). Shock was present in 45% and the case fatality rate was very high (60%). In localized melioidosis suppurative parotitis was the most common manifestation (40%). Other common infections included skin and subcutaneous abscesses and lymphadenitis. There was no shock or death in this group.