Neurological melioidosis in East Malaysia: Case series and review of the literature
- Author:
Si Lei Fong
;
Jin ShyanWong
;
Ai Huey Tan
;
Soon Chai Low
;
Chong Tin Tan
- Publication Type:Journal Article
- Keywords:
Burkholderia pseudomallei;
neurological melioidosis;
Bintulu;
Sarawak;
Malaysia
- MeSH:
Melioidosis
- From:Neurology Asia
2017;22(1):25-32
- CountryMalaysia
- Language:English
-
Abstract:
Melioidosis is an infectious disease caused by an aerobic, non-spore forming gram negative bacillus,
Burkholderia pseudomallei. It is known to be of high incidence in parts of rural South East Asia,
and in Northern Australia. Pneumonia is the commonest manifestation. We report here three cases of
neurological melioidosis from the registry of 169 cases of melioidosis in Bintulu Hospital, Sarawak,
East Malaysia, with a review of neurological melioidosis in the literature. The annual incidence of
melioidosis is estimated to be 8 per 100,000 populations in the Bintulu district. Neurological melioidosis
accounts for 1.8% of our melioidosis cases. A review of 76 cases of neurological melioidosis reported
in the literature inclusive of our 3 cases shows that localized brain or spinal inflammation or abscess
is the most common manifestation occurring in 80% of patients. Close to half (53%) have intra axial
abscess (brain or spinal cord), a quarter (27%) have extra axial lesions only (epidural or subdural
collection, osteomyelitis or scalp abscess), and another quarter (27%) have both intra and extra axial
lesions. Thus, B. pseudomallei appears to be unique among the bacterial central nervous system
infection to be able to affect the brain and its contiguous tissues, crossing the tissue plane particularly
resulting in osteomyelitis, scalp abscess and vice versa. Two thirds of the neurologicalmelioidosis
patients have only neurological disease with no evidence of disease elsewhere.
Key words: Burkholderia pseudomallei; neurological melioidosis; Bintulu; Sarawak; Malaysia
- Full text:P020170413316272592890.pdf
