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Musculoskeletal melioidosis
W Kosuwon1, S Saengnipanthkul, B Mahaisavariya
1Department of Orthopaedics and Rehabilitation Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
The Journal of Bone and Joint Surgery. American Volume
|December 1, 1993
Summary
Melioidosis, a musculoskeletal infection caused by Pseudomonas pseudomallei, is often linked to concurrent diseases like diabetes. Prompt treatment with antibiotics and surgery leads to good outcomes for most patients.
Area of Science:
- Infectious Diseases
- Musculoskeletal Infections
- Bacteriology
Background:
- Melioidosis is a serious infection caused by Pseudomonas pseudomallei.
- Musculoskeletal melioidosis presents diagnostic challenges and can be associated with other health conditions.
Purpose of the Study:
- To compare patients with musculoskeletal melioidosis to those with other musculoskeletal infections.
- To identify concurrent diseases associated with melioidosis.
- To evaluate treatment outcomes for musculoskeletal melioidosis.
Main Methods:
- A retrospective study comparing 21 patients with melioidosis to 39 patients with other musculoskeletal infections.
- Diagnosis confirmed by indirect hemagglutination test and cultures for melioidosis patients.
- Diagnosis for non-melioidosis patients based on positive cultures or histology.
Main Results:
- Concurrent diseases, particularly diabetes and thalassemia, were more common in melioidosis patients.
- Patients with concurrent disease were 12 times more likely to have melioidosis.
- Treatment involved surgical debridement and a six-month course of antibiotics (trimethoprim/sulfamethoxazole, doxycycline, kanamycin/chloramphenicol).
Conclusions:
- Musculoskeletal melioidosis requires prompt diagnosis and aggressive management.
- Effective treatment combining surgery and antibiotics leads to favorable outcomes, with 18 of 21 patients showing good results.
- Identifying concurrent diseases is crucial for suspecting and managing melioidosis.