RESUMO
Melioidosis, an infection caused by Burkholderia pseudomallei, can present as severe septicemia or localized infection. Data on optimum antibiotic treatment regimen for localized melioidosis in children is limited. This is a report on localized melioidosis in children, regarding clinical presentation, treatment and the long-term outcomes. We reviewed 37 cases of localized melioidosis in children treated between 1994 and 2006 and followed up them prospectively until 1 October 2007. The two most common presentations were skin/soft tissue infections and suppurative parotitis. Oral eradication antibiotics after initial parenteral therapy included trimetroprim-sulfamethoxazole (10 patients) and trimetroprim-sulfamethoxazole in combination with doxycycline (four patients). Patients who did not get any parenteral antibiotics for B. pseudomallei were treated with oral trimetroprim-sulfamethoxazole (10 patients) and trimetroprim-sulfamethoxazole in combination with doxycycline (one patient). No adverse effects were reported. We were able to follow-up 32 patients, all recovered except one patient reported a history of possible relapse.
Assuntos
Antibacterianos/uso terapêutico , Melioidose/tratamento farmacológico , Adolescente , Ceftazidima/uso terapêutico , Criança , Pré-Escolar , Cloranfenicol/uso terapêutico , Doxiciclina/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Lactente , Masculino , Melioidose/diagnóstico , Estudos Retrospectivos , Tailândia , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoRESUMO
We describe the treatment and follow-up results of 30 children with culture-proven melioidosis seen during 1994-1999. Twelve patients had septicemia, and 18 patients had localized infection. Ceftazidime with or without trimethoprim-sulfamethoxazole were used for the acute treatment of severe melioidosis. Oral trimethoprim-sulfamethoxazole was given in the eradication phase in 4 patients with septicemia and in 12 patients for the treatment of localized infection. Trimethoprim-sulfamethoxazole in combination with doxycycline were given to 4 patients, whereas doxycycline alone was given to 2 patients older than 8 years old. No serious adverse reaction was reported. Three patients died suddenly. Twenty-five patients could be followed up; 24 patients were well.
