Rheumatological manifestations in patients with melioidosis.
Southeast Asian J Trop Med Public Health
;
2008 Jul; 39(4): 649-55
Article
in English
| IMSEAR
| ID: sea-31881
ABSTRACT
Melioidosis, an infection caused by the bacterium Burkholderia pseudomallei, has a wide range of clinical manifestations. Here, we describe rheumatological melioidosis (involving one or more of joint, bone or muscle), and compare features and outcome with patients without rheumatological involvement. A retrospective study of patients with culture-confirmed melioidosis admitted to Sappasithiprasong Hospital, Ubon Ratchathani during 2002 and 2005 identified 679 patients with melioidosis, of whom 98 (14.4%) had rheumatological melioidosis involving joint (n=52), bone (n = 5), or muscle (n = 12), or a combination of these (n=29). Females were over-represented in the rheumatological group, and diabetes and thalassemia were independent risk factors for rheumatological involvement (OR; 2.49 and 9.56, respectively). Patients with rheumatological involvement had a more chronic course, as reflected by a longer fever clearance time (13 vs 7 days, p = 0.06) and hospitalization (22 vs 14 days, p < 0.001), but lower mortality (28% vs 44%, p = 0.005). Patients with signs and symptoms of septic arthritis for longer than 2 weeks were more likely to have extensive infection of adjacent bone and muscle, particularly in diabetic patients. Surgical intervention was associated with a survival benefit, bur not a shortening of the course of infection.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Osteomyelitis
/
Arthritis, Rheumatoid
/
Thailand
/
Female
/
Humans
/
Male
/
Arthritis, Infectious
/
Retrospective Studies
/
Risk Factors
/
Burkholderia pseudomallei
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Journal:
Southeast Asian J Trop Med Public Health
Year:
2008
Type:
Article
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