Imaging manifestations of pulmonary melioidosis: A case series.

Melioidosis is an endemic disease in Southeast Asia and Oceania caused by the gram-negative bacillus Burkholderia pseudomallei. We studied 15 adult patients from Colombia with microbiologically diagnosed pulmonary melioidosis. We reviewed 15 chest X-rays and 10 chest computed tomography (CT) studies. Of the 15 patients, 87% met the criteria for acute infection and 13% met the criteria for chronic infection. The most common findings on chest X-rays were consolidation (86%), nodules (26%), and cavitation (20%). On CT studies, consolidation and nodules were observed in 90% of cases; the areas of consolidation were predominantly located in the basal and central zones in 60%. Areas of cavitation were observed in 50%, pleural effusion in 60%, and mediastinal lymph nodes in 30%. In patients with acute pulmonary melioidosis (n=8), the findings observed were nodules (100%), mixed pattern with nodules and consolidation (87%), pleural effusion (88%), and mediastinal lymph nodes (25%). The two patients with chronic pulmonary melioidosis both had cavitation. Acute lung infection with B. Pseudomallei has radiologic manifestations similar to those of pneumonia due to other causes. In areas where the disease is endemic, it is essential to include acute melioidosis in the differential diagnosis of pulmonary nodules and chronic melioidosis in the differential diagnosis of cavitated chronic lung lesions.

Manifestaciones radiológicas de la melioidosis pulmonar. Serie de casos / Imaging manifestations of pulmonary melioidosis: a case series

La melioidosis es una enfermedad endémica en el suroeste asiático y Oceanía y está causada por la infección por el bacilo gramnegativo Burkholderia pseudomallei. Se estudian 15 pacientes adultos de Colombia con diagnóstico microbiológico de melioidosis pulmonar. Se revisaron 15 radiografías de tórax y 10 tomografías computarizadas (TC) de tórax. De los 15 pacientes, el 87% tenía criterios de infección aguda y el 13%, de infección crónica. Los hallazgos más frecuentes en la radiografía de tórax fueron: consolidación (86%), nódulos (26%) y cavitación (20%). En la tomografía computarizada se encontraron áreas de consolidación y nódulos en el 90% de los casos. En el 60% de los pacientes, las áreas de consolidación fueron de predominio basal y central. En el 50% de los casos se evidenciaron áreas de cavitación. Se evidenció derrame pleural en el 60% y adenopatías mediastínicas en el 30% de los casos. En los pacientes con presentación aguda (n=8), los hallazgos visualizados incluyeron: nódulos (100%), patrón mixto con nódulos y consolidación (87%), derrame pleural (88%) y adenopatías mediastínicas (25%). Los pacientes con melioidosis crónica (n=2) presentaron cavitación. La infección pulmonar aguda por B. Pseudomallei cursa con manifestaciones radiológicas similares a neumonías de otra etiología. En zonas endémicas debe considerarse la posibilidad de melioidosis aguda en el diagnóstico diferencial de nódulos pulmonares, y de melioidosis crónica en el diagnóstico diferencial de lesiones pulmonares crónicas cavitadas.(AU)

Melioidosis is an endemic disease in Southeast Asia and Oceania caused by the gram-negative bacillus Burkholderia pseudomallei. We studied 15 adult patients from Colombia with microbiologically diagnosed pulmonary melioidosis. We reviewed 15 chest X-rays and 10 chest computed tomography (CT) studies. Of the 15 patients, 87% met the criteria for acute infection and 13% met the criteria for chronic infection. The most common findings on chest X-rays were consolidation (86%), nodules (26%), and cavitation (20%). On CT studies, consolidation and nodules were observed in 90% of cases; the areas of consolidation were predominantly located in the basal and central zones in 60%. Areas of cavitation were observed in 50%, pleural effusion in 60%, and mediastinal lymph nodes in 30%. In patients with acute pulmonary melioidosis (n=8), the findings observed were nodules (100%), mixed pattern with nodules and consolidation (87%), pleural effusion (88%), and mediastinal lymph nodes (25%). The two patients with chronic pulmonary melioidosis both had cavitation. Acute lung infection with B. Pseudomallei has radiologic manifestations similar to those of pneumonia due to other causes. In areas where the disease is endemic, it is essential to include acute melioidosis in the differential diagnosis of pulmonary nodules and chronic melioidosis in the differential diagnosis of cavitated chronic lung lesions.(AU)

Imaging manifestations of pulmonary melioidosis: a case series. / Manifestaciones radiológicas de la melioidosis pulmonar. Serie de casos.

Melioidosis is an endemic disease in Southeast Asia and Oceania caused by the gram-negative bacillus Burkholderia pseudomallei. We studied 15 adult patients from Colombia with microbiologically diagnosed pulmonary melioidosis. We reviewed 15 chest X-rays and 10 chest computed tomography (CT) studies. Of the 15 patients, 87% met the criteria for acute infection and 13% met the criteria for chronic infection. The most common findings on chest X-rays were consolidation (86%), nodules (26%), and cavitation (20%). On CT studies, consolidation and nodules were observed in 90% of cases; the areas of consolidation were predominantly located in the basal and central zones in 60%. Areas of cavitation were observed in 50%, pleural effusion in 60%, and mediastinal lymph nodes in 30%. In patients with acute pulmonary melioidosis (n=8), the findings observed were nodules (100%), mixed pattern with nodules and consolidation (87%), pleural effusion (88%), and mediastinal lymph nodes (25%). The two patients with chronic pulmonary melioidosis both had cavitation. Acute lung infection with B. Pseudomallei has radiologic manifestations similar to those of pneumonia due to other causes. In areas where the disease is endemic, it is essential to include acute melioidosis in the differential diagnosis of pulmonary nodules and chronic melioidosis in the differential diagnosis of cavitated chronic lung lesions.