Immunopathogenesis of melioidosis liver abscess and advance in precise diagnosis and treatment
10.11816/cn.ni.2025-250886
- VernacularTitle:类鼻疽肝脓肿的免疫发病机制与精准诊疗进展
- Author:
Huimin ZHAO
1
;
Hua WU
1
Author Information
1. 海南医科大学附属海南医院(海南省人民医院)检验科,海南海口 570300
- Publication Type:Journal Article
- Keywords:
Melioidosis liver abscess;
Burkholderia pseudomallei;
Honeycomb sign;
Rapid diagnosis;
Individual-ized treatment
- From:
Chinese Journal of Nosocomiology
2025;35(22):3516-3520
- CountryChina
- Language:Chinese
-
Abstract:
Melioidosis liver abscess(MLA),caused by Burkholderia pseudomallei(Bp),is a severe infectious disease predominantly found in tropical regions such as Southeast Asia and Australia.MLA accounts for approxi-mately 12％to 18％of melioidosis cases,most frequently affecting the male population aged between 30 and 50 years old;the cases are usually complicated with diabetes or immunosuppression.Bp facilitates the formation of hepatic abscess through immune evasion mechanisms mediated by type Ⅲ/Ⅳ secretion systems,which im-pair macrophage function,dysregulate T-cell immunity,and involve TLR4 genetic variants.The typical clini-cal manifestations include right upper quadrant pain,jaundice,and persistent high fever refractory to conventional antibiotic therapy.Imaging often reveals a distinctive'honeycomb sign',and definitive diagnosis relies on Bp culture.Molecular diagnosis techniques such as clustered regularly interspaced short palindromic repeats(CRISPR)-BP34 can enhance the detection sensitivity.The treatment included two phases:intensification and e-radication,and abscesses no less than 3cm require drainage.Emerging therapeutic strategies,including combina-tion drug regimens and phage therapy,show promising potential.However,antimicrobial resistance and pro-longed treatment remain significant challenges.Future efforts should be focused on advancing rapid diagnostics,personalized therapeutic approaches and multidisciplinary collaboration so as to improve clinical outcomes.
