Urogenital Melioidosis: A Review of Clinical Presentations, Characteristic and Outcomes
- Author:
Chong Vui Heng
;
Faisal Sharif
;
Bickle Ian
- Publication Type:Journal Article
- Keywords:
Burkholderia pseudomallei;
urological sepsis;
abscesses;
presentations;
melioidosis
- From:
The Medical Journal of Malaysia
2014;69(6):257-260
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Melioidosis is endemic to the tropical regions,
in particular Thailand and Northern Australia. Any organ can
be affected by melioidosis. Involvement of the urogenital
system is common in Northern Australia, but is less
common in other regions. This study assesses the
characteristics of melioidosis affecting the urogenital
system treated in a tertiary referral centre in Brunei
Darussalam.
Material and Methods: All patients treated for melioidosis of
the urogenital system were identified and retrospectively
reviewed.
Results: There were 9 patients with 11 episodes of
urogenital infections treated over 13 years. The median age
at diagnosis was 38 years old (range 29 - 63) with men
predominantly affected. The major risk factor was
underlying diabetes mellitus (n=9), including three patients
diagnosed at the time of diagnosis of melioidosis. The
median glycosylated haemoglobin (HbA1c) was 12.8%
(range 6.4 to 16.6%). One patient’s risk factor was only
moderate alcohol consumption. Common symptoms
included; fever, lethargy, rigor and anorexia. Dysuria was
reported by two patients. The median duration of symptoms
before presentation was 7 days (range 2 to 21 days) and the
median number of sites involved were 3 (range of 2 to 6).
Urogenital involvement included prostate (n=6), kidney
(n=8), seminal vesicles (n=1) and testis (n=1). Radiological
imaging showed that large prostate abscesses (>4.5cm)
were common, and in some patients, the kidney abscess
had the ‘honeycomb’ previously described as typical for
melioidosis liver abscess. All patients were successfully
treated for melioidosis and at a median follow up of 34
months (range 1 - 97), there was one death from
complications of diabetes mellitus.
Conclusion: Urogenital melioidosis only accounted for a
small proportion of all melioidosis involvement, with
prostate and kidney most commonly affected. Concomitant
involvement of other sites were common. The major risk
factor was poorly controlled diabetes mellitus.
- Full text:P020150729467818650027.pdf
