Report of three cases of osteomyelitis caused by Burkholderia pseudomallei and literature review
10.16718/j.1009-7708.2018.01.008
- VernacularTitle:类鼻疽骨髓炎3例并文献复习
- Author:
Wenmao ZOU
1
;
Jinghui LI
;
Yufang CAO
;
Furong LIU
Author Information
1. 中南大学湘雅医学院附属海口医院重症医学科
- Keywords:
Burkholderia pseudomallei;
osteomyelitis;
diagnosis;
treatment
- From:
Chinese Journal of Infection and Chemotherapy
2018;18(1):37-43
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the clinical features,diagnosis and treatment of osteomyelitis caused by Burkholderia pseudomallei.Methods Three cases of osteomyelitis caused by B.pseudomallei were treated in Haikou People's Hospital affiliated to Xiangya Medical College of Central South University from April 2007 to April 2017.The clinical data were reviewed and analyzed retrospectively.Relevant reports of osteomyelitis due to B.pseudomallei in China and abroad from 2007 to 2017 were comprehensively reviewed.Results The clinical manifestations included hot feeling,redness,swelling,and pain at site of infection.The infection usually occurred in tibia,femur,and skull bone.There were usually multiple lesions,frequently involving spleen,soft tissue and joints.The main imaging finding was osteomyelitis.The diagnosis was confirmed by bacterial culture in all patients.Antimicrobial therapy combined with surgical intervention was the most common approach in the stage of intensive treatment.Ceftazidime,trimethoprim-sulfamethoxazole and carbapenems were the mostly used antibiotics.However,in the stage of bacterial eradication,trimethoprim-sulfamethoxazole and doxycycline were used.The duration of treatment was very long in both stages.The recurrence was low after standard treatment.Conclusions The osteomyelitis caused by B.pseudomallei lacks specific clinical manifestation.Imaging techniques can identify the site of infection,and bacterial culture helps confirm the diagnosis.Timely and effective antimicrobial therapy combined with surgical intervention can reduce mortality.Full course and standard anti-infective therapy may prevent recurrence.
