Melioidosis is an emerging infectious disease in Brazil caused by the bacteria Burkholderia pseudomallei. It presents with a wide range of clinical symptoms from severe pneumonia and bloodstream infection to less severe soft tissue infection. Diagnosis relies on culturing B. pseudomallei from clinical samples, but it can be difficult to identify and confused with other bacteria. Treatment requires intravenous antibiotics such as ceftazidime or meropenem for several weeks followed by 3-5 months of oral antibiotics to prevent relapse. Consistent use of diagnostic testing and the correct antibiotic treatment regimen is needed to reduce mortality from melioidosis.
Melioidosis is caused by the bacterium Burkholderia pseudomallei, which is found in soil and water in tropical and subtropical regions. It was first identified in 1912 in Burma and causes a range of illnesses from localized skin infections to severe pneumonia and bloodstream infections. The disease mainly affects rice farmers and is endemic in Southeast Asia and northern Australia. Transmission occurs through contact with contaminated soil or water, and the greatest risk is during the rainy season when bacteria can be aerosolized. Treatment involves long-term antibiotics and surgical drainage of abscesses.
This document summarizes different types and stages of tuberculosis infection and disease. It describes primary tuberculosis occurring in previously unexposed individuals, which may lead to fibrosis and healing or progressive primary disease. It also describes secondary or reactivation tuberculosis occurring in sensitized hosts, which typically involves the lung apices and may progress to cavitary lesions if not treated properly. The document discusses the pathology, microbiology, immunology and clinical manifestations of tuberculosis at different stages.
Melioidosis- An overview, covers the Aetiology, Epidemiology, World as well as Indian Scenario of Meliodosis, Its public health impact, control strategy and Indian Research prospects of the disease.
All credit goes to Dr. Gazanfar Abass, MVSc Scholar at Division of Veterinary Public Health, Indian Veterinary Research Institute, izatnagar UP, India
Cholera is devastating diarrheal disease caused by V. Cholerae that has been responsible for seven global pandemics.
Epidemic cholera remains a significant public health concern in the developing world today.
Lyme disease is caused by bacteria transmitted through tick bites. Early symptoms may include a rash or flu-like symptoms. Left untreated, later stages can involve joints, heart, or nervous system. Diagnosis involves symptoms, possible exposure, and optional blood tests. Treatment uses antibiotics. While most recover fully, 10-20% develop lingering symptoms termed Post-treatment Lyme Disease Syndrome. Prevention focuses on tick avoidance and repellent use.
This document defines non-resolving pneumonia and discusses its causes and diagnostic evaluation. Non-resolving pneumonia is defined as persistence of clinical symptoms and radiographic abnormalities for longer than expected despite adequate antibiotic therapy. Common causes include inappropriate antibiotic therapy, complications of the initial infection, host factors, and presence of resistant or unusual pathogens. A thorough diagnostic evaluation includes assessing treatment response, looking for complications or superinfections, evaluating for unusual organisms, and examining host immune function. Radiological imaging, bronchoscopy with protected specimen brushing or biopsy, and CT-guided biopsies can help identify causative organisms or underlying conditions.
This document provides information about measles (rubeola), including:
- It is caused by the measles virus, a single-stranded RNA virus that is highly contagious and spreads through coughs/sneezes.
- Clinical features include fever, cough, runny nose, red eyes, and a red maculopapular rash. Tiny white spots inside the mouth called Koplik's spots may also appear.
- There is no antiviral treatment, so care involves hydration, rest, and antibiotics if bacterial infections develop. Complications can include pneumonia, brain infections, and death in rare cases.
- Prevention is through passive immunization with immunoglobulin or active immunization
Melioidosis is caused by the bacterium Burkholderia pseudomallei, which is found in soil and water in tropical and subtropical regions. It was first identified in 1912 in Burma and causes a range of illnesses from localized skin infections to severe pneumonia and bloodstream infections. The disease mainly affects rice farmers and is endemic in Southeast Asia and northern Australia. Transmission occurs through contact with contaminated soil or water, and the greatest risk is during the rainy season when bacteria can be aerosolized. Treatment involves long-term antibiotics and surgical drainage of abscesses.
This document summarizes different types and stages of tuberculosis infection and disease. It describes primary tuberculosis occurring in previously unexposed individuals, which may lead to fibrosis and healing or progressive primary disease. It also describes secondary or reactivation tuberculosis occurring in sensitized hosts, which typically involves the lung apices and may progress to cavitary lesions if not treated properly. The document discusses the pathology, microbiology, immunology and clinical manifestations of tuberculosis at different stages.
Melioidosis- An overview, covers the Aetiology, Epidemiology, World as well as Indian Scenario of Meliodosis, Its public health impact, control strategy and Indian Research prospects of the disease.
All credit goes to Dr. Gazanfar Abass, MVSc Scholar at Division of Veterinary Public Health, Indian Veterinary Research Institute, izatnagar UP, India
Cholera is devastating diarrheal disease caused by V. Cholerae that has been responsible for seven global pandemics.
Epidemic cholera remains a significant public health concern in the developing world today.
Lyme disease is caused by bacteria transmitted through tick bites. Early symptoms may include a rash or flu-like symptoms. Left untreated, later stages can involve joints, heart, or nervous system. Diagnosis involves symptoms, possible exposure, and optional blood tests. Treatment uses antibiotics. While most recover fully, 10-20% develop lingering symptoms termed Post-treatment Lyme Disease Syndrome. Prevention focuses on tick avoidance and repellent use.
This document defines non-resolving pneumonia and discusses its causes and diagnostic evaluation. Non-resolving pneumonia is defined as persistence of clinical symptoms and radiographic abnormalities for longer than expected despite adequate antibiotic therapy. Common causes include inappropriate antibiotic therapy, complications of the initial infection, host factors, and presence of resistant or unusual pathogens. A thorough diagnostic evaluation includes assessing treatment response, looking for complications or superinfections, evaluating for unusual organisms, and examining host immune function. Radiological imaging, bronchoscopy with protected specimen brushing or biopsy, and CT-guided biopsies can help identify causative organisms or underlying conditions.
This document provides information about measles (rubeola), including:
- It is caused by the measles virus, a single-stranded RNA virus that is highly contagious and spreads through coughs/sneezes.
- Clinical features include fever, cough, runny nose, red eyes, and a red maculopapular rash. Tiny white spots inside the mouth called Koplik's spots may also appear.
- There is no antiviral treatment, so care involves hydration, rest, and antibiotics if bacterial infections develop. Complications can include pneumonia, brain infections, and death in rare cases.
- Prevention is through passive immunization with immunoglobulin or active immunization
Malaria is caused by Plasmodium parasites transmitted via mosquito bites. It has a complex life cycle alternating between human and mosquito hosts. The disease ranges from mild to severe depending on parasite species and host immune status. Common symptoms include fevers, chills, and flu-like illness. Severe malaria can involve cerebral symptoms, severe anemia, respiratory distress, and other complications without prompt treatment. Transmission is dependent on environmental factors permitting parasite and vector survival.
- Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei found in soil and water in Southeast Asia and northern Australia. It is contracted through contact with contaminated soil or water.
- Symptoms range from skin ulcers to pulmonary or disseminated infection. Diagnosis involves culture of the bacteria from clinical samples which grows readily on laboratory media. Treatment requires prolonged use of antibiotics like ceftazidime or cotrimoxazole to which the bacteria is intrinsically resistant. There is currently no vaccine available for melioidosis.
RSV is a common virus that usually causes mild upper respiratory tract infections but can sometimes lead to pneumonia or bronchiolitis in young children. It is transmitted through respiratory secretions and contaminated surfaces. While infection leads to immunity against that RSV subtype, reinfection is still possible. Diagnosis involves antigen detection, viral culture, or PCR from respiratory samples. Treatment is supportive, though ribavirin may help severe cases. Development of an effective vaccine remains an ongoing effort.
A HIV-infected patient presents with cough, fever and sputum production for 4 days. A chest X-ray shows a left lower lobe infiltrate and the patient has a low CD4 count of 150/mm3. The most likely pathogen is Pneumocystis jirovecii (previously known as P. carinii) given the presentation and severe immunosuppression. PCP is a common opportunistic infection in patients with advanced HIV/AIDS. Diagnosis requires staining of respiratory samples for visualization of the organism, with BAL having the highest diagnostic yield. Treatment involves anti-pneumocystis medications.
Leptospirosis is a bacterial disease caused by Leptospira bacteria that can infect both humans and animals. It is transmitted through contact with water or soil contaminated by the urine of infected animals. Common symptoms include fever, headache, muscle aches, vomiting, and jaundice. The incubation period is usually 10 days. Diagnosis is confirmed through lab tests of body fluids and tissues. Treatment involves antibiotics like penicillin or doxycycline. Prevention relies on vaccination of animals, proper sanitation, and health education.
Rickettsiae are intracellular bacteria transmitted by ticks, mites, fleas or lice. Rickettsial infections cause fever, rash, and enlargement of organs
Leprosy is a chronic infectious disease caused by Mycobacterium leprae that attacks the nervous system and skin. It causes numbness and visible deformities as it destroys nerves and cartilage in affected areas over time. The diagnosis is made based on sensory loss and skin lesions. Treatment involves multidrug regimens containing dapsone, clofazimine, and rifampicin over the course of 6 months to 2 years depending on the classification of paucibacillary or multibacillary leprosy. Side effects of the drugs include rashes, discolored skin, and severe itching which usually resolve after treatment completion.
- There is an estimated 1 million people worldwide who have TB and HIV co-infection, with a high burden in sub-Saharan Africa and Asia.
- People living with HIV are 26-31 times more likely to develop TB than those without HIV. TB is the most common illness in those with HIV and a major cause of HIV-related death.
- Clinical manifestations of TB in those with HIV depend on immune deficiency level, ranging from typical localized TB to atypical disseminated forms with more advanced HIV disease. Diagnosis involves screening algorithms, radiography, sputum smear microscopy, mycobacterial culture, and molecular and serological tests.
This document discusses the role of antifibrotic agents in treating pulmonary fibrosis post COVID-19 pneumonia. It provides background on COVID-19 and pulmonary fibrosis. Risk factors for developing pulmonary fibrosis after COVID-19 include older age, illness severity, length of ICU stay and mechanical ventilation. Two main antifibrotic drugs discussed are nintedanib and pirfenidone. Nintedanib works by inhibiting tyrosine kinases and pirfenidone has anti-fibrotic, anti-inflammatory and antioxidant properties. Both drugs show potential for treating or preventing pulmonary fibrosis caused by COVID-19.
The document discusses the interaction between tuberculosis (TB) and HIV on epidemiological, clinical, and cellular levels. It notes that HIV is the strongest risk factor for reactivation of latent TB infection. Co-infection increases morbidity and mortality as HIV increases the risk of developing active TB disease. A coordinated public health approach is needed that includes intensified case finding, infection control, and isoniazid prophylaxis to address the synergistic relationship between TB and HIV.
* SLE can affect all components of the respiratory system, with clinical presentations ranging from asymptomatic to life-threatening.
* Pleural effusion is the most common pulmonary manifestation in SLE and usually presents as bilateral, small or moderate exudative effusions that resolve spontaneously without residual damage.
* Diffuse alveolar hemorrhage is a serious pulmonary complication characterized by hemoptysis, rapid drop in hemoglobin, and new infiltrates on imaging, requiring aggressive immunosuppression.
Pulmonary tuberculoma is a form of tuberculosis involving encapsulated caseous lesions over 1 cm in diameter in the lungs, which occurs in around 4-6% of tuberculosis cases. Tuberculomas can be classified based on their structure and can develop from different forms of tuberculosis infection. They are typically diagnosed through radiological imaging showing rounded masses and response to tuberculin tests. Treatment involves a standard multidrug regimen over an intensive and continuation phase, and surgery may also be used in some cases. The prognosis is usually favorable with timely treatment.
This document discusses histoplasmosis, an infection caused by the fungus Histoplasma capsulatum. The fungus lives in soil containing bird or bat droppings. There are two main types - pulmonary histoplasmosis, which occurs when the fungus is inhaled, and disseminated histoplasmosis, which spreads from the lungs. Symptoms can include fever, cough, fatigue and chest pain. Diagnosis involves examining samples under a microscope for the yeast cells or culturing samples. Treatment uses antifungal medications such as itraconazole or amphotericin B, depending on severity.
Rickettsiae are small, obligate intracellular bacteria that are parasites of arthropods like fleas, ticks and mites. They can infect humans and cause diseases like typhus, spotted fever and scrub typhus. Symptoms typically include fever, rash and vasculitis. Rickettsiae are pleomorphic and stain differently with various stains. They are transmitted via arthropod bites or feces and infect endothelial cells. Diagnosis involves microscopic examination, animal inoculation, serology and PCR. Tetracyclines are the treatment of choice if given early.
Haemophilus influenzae is a Gram-negative bacterium that can cause several types of infections in humans, most notably meningitis in young children. There are six serotypes of H. influenzae defined by their capsular polysaccharides. Type b is the most virulent and was a major cause of childhood meningitis, pneumonia, and epiglottitis prior to the development of effective vaccines in the 1990s. Diagnosis involves culture and identification of the bacteria, while treatment requires prompt antibiotic therapy. Vaccination against H. influenzae type b has dramatically reduced the incidence of invasive disease in children under 5 years old.
Neisseria meninigitidis-brain infection,meningococcalSelvajeyanthi S
Neisseria meninigitidis
brain infection,meningococcal disease
meningococcemia-a life-threatening sepsis.
high mortality and morbidity,meningococcal disease needs immediate medical attention
initial adherence to the nasopharyngeal (nose and throat) mucosa to invasion of the deeper mucosal layers
This document discusses drug susceptibility testing, which determines if microbes like bacteria or fungi can be inhibited by antimicrobial drugs. There are two main types of testing - qualitative for less serious infections, and quantitative for serious infections. The Kirby-Bauer disk diffusion method is commonly used, involving placing disks with antibiotics on agar plated with a test organism. The size of the inhibition zone is measured to determine resistance or susceptibility. Factors like incubation time and temperature affect results. Minimum inhibitory concentration methods like broth dilution are also used but are more complex. Computer programs help analyze and track susceptibility data.
Poliomyelitis, commonly known as polio, is an acute viral infectious disease that is spread through the fecal-oral route. There are three types of poliovirus that can cause the disease. While most infections cause mild symptoms, in rare cases the virus infects the central nervous system and causes paralysis. The disease was once widespread but vaccination programs have largely eradicated it in most countries. Immunization is the primary method of prevention and treatment focuses on relieving symptoms since there is no cure for the viral infection.
Diagnosis of fungal disease by Dr. Manoj karkimanojj123
Early diagnosis of fungal infection is critical for effective treatment. History, clinical signs, gross pathology and in few cases intradermal skin test are all of the value in the diagnosis of clinical specimens.
Basic description of Lyme disease from Microbiological and Clinical point of view with discussion on Pathology, Clinical Features and, Laboratory Diagnosis.
This document discusses Candida infections in the ICU, including epidemiology, risk factors, pathogenesis, diagnosis, and treatment. Some key points:
- Candida species are the most common fungal pathogens in hospitals and ICUs, responsible for 17% of healthcare-associated infections. Non-albicans Candida species now account for around 50% of infections.
- Risk factors for invasive Candida infections include prolonged ICU stay, broad-spectrum antibiotic use, surgery, and underlying conditions like diabetes that impair immunity. Heavy Candida colonization is an independent risk factor.
- Diagnosis is challenging as symptoms mimic bacterial infections. Culture-based methods are slow. Biomarkers like beta-D-
This document provides guidelines for managing opportunistic mycobacterial infections. It discusses the epidemiology, diagnosis, and treatment of these infections. For pulmonary disease caused by M. kansasii in HIV-negative patients, the guidelines recommend treatment with rifampicin and ethambutol for 9 months based on prospective studies showing high cure rates without relapse. For patients with compromised immunity, treatment should continue for 15-24 months or until sputum cultures are negative for 12 months. Relapses should be retreated with rifampicin and ethambutol for 15-24 months, adding prothionamide and streptomycin for non-responders.
Malaria is caused by Plasmodium parasites transmitted via mosquito bites. It has a complex life cycle alternating between human and mosquito hosts. The disease ranges from mild to severe depending on parasite species and host immune status. Common symptoms include fevers, chills, and flu-like illness. Severe malaria can involve cerebral symptoms, severe anemia, respiratory distress, and other complications without prompt treatment. Transmission is dependent on environmental factors permitting parasite and vector survival.
- Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei found in soil and water in Southeast Asia and northern Australia. It is contracted through contact with contaminated soil or water.
- Symptoms range from skin ulcers to pulmonary or disseminated infection. Diagnosis involves culture of the bacteria from clinical samples which grows readily on laboratory media. Treatment requires prolonged use of antibiotics like ceftazidime or cotrimoxazole to which the bacteria is intrinsically resistant. There is currently no vaccine available for melioidosis.
RSV is a common virus that usually causes mild upper respiratory tract infections but can sometimes lead to pneumonia or bronchiolitis in young children. It is transmitted through respiratory secretions and contaminated surfaces. While infection leads to immunity against that RSV subtype, reinfection is still possible. Diagnosis involves antigen detection, viral culture, or PCR from respiratory samples. Treatment is supportive, though ribavirin may help severe cases. Development of an effective vaccine remains an ongoing effort.
A HIV-infected patient presents with cough, fever and sputum production for 4 days. A chest X-ray shows a left lower lobe infiltrate and the patient has a low CD4 count of 150/mm3. The most likely pathogen is Pneumocystis jirovecii (previously known as P. carinii) given the presentation and severe immunosuppression. PCP is a common opportunistic infection in patients with advanced HIV/AIDS. Diagnosis requires staining of respiratory samples for visualization of the organism, with BAL having the highest diagnostic yield. Treatment involves anti-pneumocystis medications.
Leptospirosis is a bacterial disease caused by Leptospira bacteria that can infect both humans and animals. It is transmitted through contact with water or soil contaminated by the urine of infected animals. Common symptoms include fever, headache, muscle aches, vomiting, and jaundice. The incubation period is usually 10 days. Diagnosis is confirmed through lab tests of body fluids and tissues. Treatment involves antibiotics like penicillin or doxycycline. Prevention relies on vaccination of animals, proper sanitation, and health education.
Rickettsiae are intracellular bacteria transmitted by ticks, mites, fleas or lice. Rickettsial infections cause fever, rash, and enlargement of organs
Leprosy is a chronic infectious disease caused by Mycobacterium leprae that attacks the nervous system and skin. It causes numbness and visible deformities as it destroys nerves and cartilage in affected areas over time. The diagnosis is made based on sensory loss and skin lesions. Treatment involves multidrug regimens containing dapsone, clofazimine, and rifampicin over the course of 6 months to 2 years depending on the classification of paucibacillary or multibacillary leprosy. Side effects of the drugs include rashes, discolored skin, and severe itching which usually resolve after treatment completion.
- There is an estimated 1 million people worldwide who have TB and HIV co-infection, with a high burden in sub-Saharan Africa and Asia.
- People living with HIV are 26-31 times more likely to develop TB than those without HIV. TB is the most common illness in those with HIV and a major cause of HIV-related death.
- Clinical manifestations of TB in those with HIV depend on immune deficiency level, ranging from typical localized TB to atypical disseminated forms with more advanced HIV disease. Diagnosis involves screening algorithms, radiography, sputum smear microscopy, mycobacterial culture, and molecular and serological tests.
This document discusses the role of antifibrotic agents in treating pulmonary fibrosis post COVID-19 pneumonia. It provides background on COVID-19 and pulmonary fibrosis. Risk factors for developing pulmonary fibrosis after COVID-19 include older age, illness severity, length of ICU stay and mechanical ventilation. Two main antifibrotic drugs discussed are nintedanib and pirfenidone. Nintedanib works by inhibiting tyrosine kinases and pirfenidone has anti-fibrotic, anti-inflammatory and antioxidant properties. Both drugs show potential for treating or preventing pulmonary fibrosis caused by COVID-19.
The document discusses the interaction between tuberculosis (TB) and HIV on epidemiological, clinical, and cellular levels. It notes that HIV is the strongest risk factor for reactivation of latent TB infection. Co-infection increases morbidity and mortality as HIV increases the risk of developing active TB disease. A coordinated public health approach is needed that includes intensified case finding, infection control, and isoniazid prophylaxis to address the synergistic relationship between TB and HIV.
* SLE can affect all components of the respiratory system, with clinical presentations ranging from asymptomatic to life-threatening.
* Pleural effusion is the most common pulmonary manifestation in SLE and usually presents as bilateral, small or moderate exudative effusions that resolve spontaneously without residual damage.
* Diffuse alveolar hemorrhage is a serious pulmonary complication characterized by hemoptysis, rapid drop in hemoglobin, and new infiltrates on imaging, requiring aggressive immunosuppression.
Pulmonary tuberculoma is a form of tuberculosis involving encapsulated caseous lesions over 1 cm in diameter in the lungs, which occurs in around 4-6% of tuberculosis cases. Tuberculomas can be classified based on their structure and can develop from different forms of tuberculosis infection. They are typically diagnosed through radiological imaging showing rounded masses and response to tuberculin tests. Treatment involves a standard multidrug regimen over an intensive and continuation phase, and surgery may also be used in some cases. The prognosis is usually favorable with timely treatment.
This document discusses histoplasmosis, an infection caused by the fungus Histoplasma capsulatum. The fungus lives in soil containing bird or bat droppings. There are two main types - pulmonary histoplasmosis, which occurs when the fungus is inhaled, and disseminated histoplasmosis, which spreads from the lungs. Symptoms can include fever, cough, fatigue and chest pain. Diagnosis involves examining samples under a microscope for the yeast cells or culturing samples. Treatment uses antifungal medications such as itraconazole or amphotericin B, depending on severity.
Rickettsiae are small, obligate intracellular bacteria that are parasites of arthropods like fleas, ticks and mites. They can infect humans and cause diseases like typhus, spotted fever and scrub typhus. Symptoms typically include fever, rash and vasculitis. Rickettsiae are pleomorphic and stain differently with various stains. They are transmitted via arthropod bites or feces and infect endothelial cells. Diagnosis involves microscopic examination, animal inoculation, serology and PCR. Tetracyclines are the treatment of choice if given early.
Haemophilus influenzae is a Gram-negative bacterium that can cause several types of infections in humans, most notably meningitis in young children. There are six serotypes of H. influenzae defined by their capsular polysaccharides. Type b is the most virulent and was a major cause of childhood meningitis, pneumonia, and epiglottitis prior to the development of effective vaccines in the 1990s. Diagnosis involves culture and identification of the bacteria, while treatment requires prompt antibiotic therapy. Vaccination against H. influenzae type b has dramatically reduced the incidence of invasive disease in children under 5 years old.
Neisseria meninigitidis-brain infection,meningococcalSelvajeyanthi S
Neisseria meninigitidis
brain infection,meningococcal disease
meningococcemia-a life-threatening sepsis.
high mortality and morbidity,meningococcal disease needs immediate medical attention
initial adherence to the nasopharyngeal (nose and throat) mucosa to invasion of the deeper mucosal layers
This document discusses drug susceptibility testing, which determines if microbes like bacteria or fungi can be inhibited by antimicrobial drugs. There are two main types of testing - qualitative for less serious infections, and quantitative for serious infections. The Kirby-Bauer disk diffusion method is commonly used, involving placing disks with antibiotics on agar plated with a test organism. The size of the inhibition zone is measured to determine resistance or susceptibility. Factors like incubation time and temperature affect results. Minimum inhibitory concentration methods like broth dilution are also used but are more complex. Computer programs help analyze and track susceptibility data.
Poliomyelitis, commonly known as polio, is an acute viral infectious disease that is spread through the fecal-oral route. There are three types of poliovirus that can cause the disease. While most infections cause mild symptoms, in rare cases the virus infects the central nervous system and causes paralysis. The disease was once widespread but vaccination programs have largely eradicated it in most countries. Immunization is the primary method of prevention and treatment focuses on relieving symptoms since there is no cure for the viral infection.
Diagnosis of fungal disease by Dr. Manoj karkimanojj123
Early diagnosis of fungal infection is critical for effective treatment. History, clinical signs, gross pathology and in few cases intradermal skin test are all of the value in the diagnosis of clinical specimens.
Basic description of Lyme disease from Microbiological and Clinical point of view with discussion on Pathology, Clinical Features and, Laboratory Diagnosis.
This document discusses Candida infections in the ICU, including epidemiology, risk factors, pathogenesis, diagnosis, and treatment. Some key points:
- Candida species are the most common fungal pathogens in hospitals and ICUs, responsible for 17% of healthcare-associated infections. Non-albicans Candida species now account for around 50% of infections.
- Risk factors for invasive Candida infections include prolonged ICU stay, broad-spectrum antibiotic use, surgery, and underlying conditions like diabetes that impair immunity. Heavy Candida colonization is an independent risk factor.
- Diagnosis is challenging as symptoms mimic bacterial infections. Culture-based methods are slow. Biomarkers like beta-D-
This document provides guidelines for managing opportunistic mycobacterial infections. It discusses the epidemiology, diagnosis, and treatment of these infections. For pulmonary disease caused by M. kansasii in HIV-negative patients, the guidelines recommend treatment with rifampicin and ethambutol for 9 months based on prospective studies showing high cure rates without relapse. For patients with compromised immunity, treatment should continue for 15-24 months or until sputum cultures are negative for 12 months. Relapses should be retreated with rifampicin and ethambutol for 15-24 months, adding prothionamide and streptomycin for non-responders.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This document summarizes information about Buruli ulcer, a chronic skin disease caused by Mycobacterium ulcerans. It describes the typical presentation as painless skin lesions that slowly ulcerate. Peak incidence is in children ages 5-15 in central and western Africa near slow-moving bodies of water. While the mode of transmission is unknown, water bugs and fish are believed to carry the bacteria. Treatment involves antibiotics like rifampicin and streptomycin or clarithromycin, with surgery reserved for advanced cases to prevent deformities from scarring.
Clostridium difficile (C. diff) is a bacteria that commonly causes infections in healthcare facilities. It is associated with antibiotic use, which disrupts the normal gut flora and allows C. diff to colonize. C. diff produces toxins that cause inflammation and symptoms like diarrhea. It is a significant healthcare problem, especially for the elderly, young children, and hospitalized patients. Tracking the epidemiology of C. diff is challenging due to limitations in record-keeping in some parts of the world. Treatment can also be difficult as the infection is often linked to antibiotic use.
Bacterial Meningitis in Paediatrics A Review.pdfPUBLISHERJOURNAL
Emmanuel Ifeanyi Obeagu1, Sowdo Abdirizak Mohamed2, Ugwu Okechukwu Paul-Chima3, Getrude Uzoma Obeagu4 and Chukwunalu Igbudu Umoke5
1Department of Medical Laboratory Science, Kampala International University, Uganda.
2Department of Pediatrics, Kampala International University, Uganda.
3Department of Publication and Extension, Kampala International University, Uganda.
4Department of Nursing Science, Kampala International University, Uganda.
5Department of Human Anatomy, Alex Ekwueme Federal University, Ndufu Alike, Ikwo, Ebonyi State, Nigeria.
Email:emmanuelobeagu@yahoo.com
________________________________________
ABSTRACT
Meningitis is a potentially life-threatening condition characterized by infection or inflammation of the central nervous system. It is classified as bacterial, viral, or aseptic. Delayed or untreated bacterial meningitis is associated with high morbidity and mortality. It is important to accurately distinguish between bacterial and nonbacterial meningitis. Most physicians will perform a lumbar puncture and consider antibiotics for all infants and children with suspected meningitis. Having a clinical prediction rule to determine the need for lumbar puncture and which patients need antibiotics could reduce morbidity and the cost associated with unnecessary procedures and treatment. Several clinical prediction rules to determine the risk of bacterial meningitis have been proposed. One clinical prediction rule, derived and validated from cohorts seen in pediatric hospitals in the Netherlands, found that altered consciousness, meningeal irritation, cyanosis, petechiae, vomiting, duration of main symptom, and an elevated C-reactive protein and Erythrocyte Sedimentation Rate level were independent predictors of bacterial meningitis. Patients below a predefined threshold on a risk score incorporating these elements could be safely considered as not having bacterial meningitis.
Keywords: Bacteria, Meningitis, petechiae, C - reactive protein, pediatrics, ESR
This document discusses neonatal sepsis. It defines key terms like infection, SIRS, bacteremia, toxemia, and septicemia. It describes the pathogenesis of neonatal sepsis, noting deficiencies in the neonatal immune system that increase susceptibility to infection. It discusses the epidemiology of neonatal sepsis globally and risk factors like prematurity. Common causes of early-onset and late-onset sepsis are bacterial and viral pathogens transmitted from mother to infant during or after birth.
This document discusses neonatal sepsis. It defines key terms like infection, SIRS, bacteremia, toxemia, and septicemia. It describes the pathogenesis of neonatal sepsis, noting deficiencies in the infant's immune system that increase susceptibility. It also discusses the epidemiology, noting higher rates in developing countries and preterm/low birthweight infants. Common causes include group B streptococcus, E. coli, and other gram-negative bacteria. Morbidity and mortality remain high without prompt treatment.
1. This case report describes a 10-month-old male infant who presented with Pseudomonas aeruginosa bacteremia and was subsequently diagnosed with C2 deficiency type 1.
2. C2 deficiency results in susceptibility to encapsulated bacterial infections. This is the first reported case of C2 deficiency presenting with Pseudomonas aeruginosa, an atypical pathogen for this condition.
3. Genetic testing confirmed the patient had homozygous C2 deficiency type 1. Evaluation of the complement system is important for understanding susceptibility to unusual infections like Pseudomonas bacteremia.
Etiologia de la celulitis y Predicción clínica de la enfermedad Estreptocócic...Alex Castañeda-Sabogal
Etiologia de la celulitis. Estudio prospectivo y predicción clínica de la infeccion por Estreptococcus basado en la frecuencia encontrada de las especies de estreptococo
This document discusses acute community-acquired bacterial meningitis in adults. It begins by stating that the most common causes are Streptococcus pneumoniae and Neisseria meningitidis. It emphasizes that a lumbar puncture is needed to diagnose bacterial meningitis and identify the causative organism. While symptoms are not specific, prompt diagnosis and treatment are important as bacterial meningitis can have high rates of morbidity and mortality.
Is Clostridium Difficile still a problem in UK hospitalsCarl Aston
The document discusses Clostridium difficile (C. difficile) infections in UK hospitals. It notes that C. difficile is a common cause of antibiotic-resistant diarrhea and more severe infections can occur. Hospital-acquired C. difficile infections increased sharply in the UK from 1990-2004. In response, the UK government issued new guidelines in 2008 to combat the infection rate. The guidelines focused on early detection and isolation of suspected C. difficile cases as well as environmental cleaning to prevent transmission of the hardy spores that allow the bacteria to spread. While still an issue, adherence to the guidelines has helped reduce C. difficile infection rates in UK hospitals.
Clostridium difficile is a bacterium that causes intestinal infections and can be life-threatening. It is becoming more common in hospitals and long-term care facilities. Standard treatments include antibiotics, but some strains are resistant. Probiotics may help prevent and treat C. difficile infections by replacing normal gut bacteria. Preliminary clinical trials found probiotic supplements containing Lactobacillus, Bifidobacterium, and Saccharomyces yeast reduced the risk of C. difficile infections in hospitals and recurrences after treatment. However, more research is still needed to establish effective probiotic treatment protocols.
Diagnostic Approaches to Chronic Fungal and Tuberculous Meningitisinventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Pneumonia is a common lung infection that can be caused by bacteria, viruses, fungi or parasites. It results in inflammation and fluid in the alveoli, causing symptoms like cough, chest pain, fever and difficulty breathing. The most common bacterial causes are Streptococcus pneumoniae and atypical bacteria. Pneumonia poses greater risks for elderly people, young children, and those with weakened immune systems. Diagnosis involves tests like chest x-rays and treatment differs based on the identified cause.
Community Acquired Pneumonia (CAP) in Children Presentation Prepared by MrMWSKMrMWSK .
Community-acquired pneumonia (CAP) is common in children, especially those under 5 years old. Viruses are a common cause, particularly respiratory syncytial virus in infants. Streptococcus pneumoniae is the most common bacterial cause. Clinical features like fever, tachypnea, and chest wall recession are used to diagnose CAP, but tests are not usually needed. Oral amoxicillin is usually sufficient treatment but intravenous antibiotics may be needed for severe cases. Complications can include empyema or necrotizing pneumonia. Vaccines against pneumococcus and influenza help reduce CAP incidence.
This document discusses nontuberculous mycobacteria (NTM), which are environmental bacteria that can sometimes cause disease in humans. It describes the main NTM species, how they are classified, the diseases they can cause such as pulmonary or skin infections, and their treatment. Key points include:
- NTM are common in water and soil and can cause opportunistic infections, especially in people with lung disease or who are immunosuppressed.
- Pulmonary NTM disease is the most common clinical syndrome and presents as either nodular/bronchiectatic or fibrocavitary patterns on imaging.
- Treatment involves multiple antimicrobials for prolonged periods but has limited success due to drug toxicity and recurrence
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Melioidosis
1. Rev. Inst. Med. trop. S. Paulo
48(1):1-4, January-February, 2006
CLINICAL GUIDELINE FOR DIAGNOSIS AND MANAGEMENT OF MELIOIDOSIS
Timothy J.J. INGLIS(1), Dionne B. ROLIM(2) & Jorge L.N. RODRIGUEZ(3)
SUMMARY
Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical
presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft
tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the
bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be
difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant
culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive
diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates.
Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed
by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of
diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two
stages; acute and eradication, will contribute to a reduction in mortality from melioidosis.
KEYWORDS: Melioidosis; Clinical guideline; Diagnosis; Antibiotics; Burkholderia pseudomallei.
INTRODUCTION suggest B. pseudomallei so that the opportunity to make a definitive
early diagnosis may be missed. By this stage, usually 1-2 days after
Melioidosis is an emerging infectious disease in Brazil. This collection of a blood or sputum culture, a severely sick patient may be
potentially fatal bacterial infection is caused by exposure to soil or in respiratory distress or even dead. The methods used to identify Gram
water contaminated with the bacterial species Burkholderia negative bacteria in the microbiology laboratory can be very misleading.
pseudomallei. The disease has been known in the Americas since the Some do not reliably identify B. pseudomallei at all9. Physicians and
middle of the 20th century when there was an outbreak in sheep, goats microbiologists need to know how to look for B. pseudomallei to
and pigs in Aruba24. Since then sporadic cases of melioidosis have increase their chances of detecting it.
occurred in Ecuador, Panama and possibly in Ceara1,19. The recent
cluster of melioidosis fatalities in rural Ceara has highlighted the Antibiotic treatment of melioidosis also poses a challenge. Several
changing epidemiology of this disease. Survey data from Northeastern antibiotics commonly used for Gram negative septicaemia, including
Brazil indicates that melioidosis is a more important cause of Gentamicin, quinolones and third generation cephalosporins have no
community-acquired sepsis than previously thought21. reliable effect against B. pseudomallei infection¹³. The preferred
antibiotic treatment of B. pseudomallei septicaemia requires costly
A recurring issue where melioidosis is known but uncommon is intravenous agents3,27. There is a tendency for early relapse at around
how best to confirm the diagnosis. In its most acute, life threatening 10-14 days after commencement of intravenous antibiotic therapy².
form the infection has no reliable pathognomonic features³¹. The Late relapse can occur months or even years after initial septicaemic
differential diagnosis is very wide. Baseline diagnostic tests offer little infection. An additional consequence of this capacity for melioidosis
help. The definitive diagnosis depends on culture of the causal bacterial to remain dormant is delayed presentation of acute infection many
species, B. pseudomallei15 . But even when preliminary culture results decades after the initial exposure18.
are returned from the microbiology laboratory, the result may not be
apparent because Gram negative septicaemia has many commoner In order to raise awareness of the clinical management issues, we
causes. The appearance of B. pseudomallei colonies on an agar plate present our recommendations for diagnosis, treatment and continuing
can be helpful after subculture from blood culture bottles onto solid care of melioidosis based on recent experience and best practice. These
media, but only after 2-3 days of growth. Younger cultures may not guidelines will be subject to revision as diagnostic and therapeutic
(1) Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA 6909, Australia.
(2) Hospital São José, Fortaleza, Estado do Ceará, Brasil.
(3) Universidade Federal do Ceará, Fortaleza, Estado do Ceará, Brasil.
Correspondence to: Timothy J.J. Inglis, Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA 6909,
Australia. Fax +618 9381 7139. Tel: +618 9346 3461. E-mail: Tim.inglis@health.wa.gov.au.
2. INGLIS, T.J.J.; ROLIM, D.B. & RODRIGUEZ, J.L.N. - Clinical guideline for diagnosis and management of melioidosis. Rev. Inst. Med. trop. S. Paulo, 48(1): 1-4, 2006.
systems improve to meet the challenges posed by this emerging (CFU/mL) can reach high levels during septicaemia and B. pseudomallei
infection. grows easily so that conventional blood culture methods are an effective
means of establishing a bacteriological diagnosis28. Samples from non-
CASE DESCRIPTION sterile sites are less helpful because the numbers of B. pseudomallei
may be much lower, and can be overwhelmed by larger numbers of
There are no reliable pathognomonic features of acute or subacute commensal species. This problem can be overcome by use of selective
melioidosis. Other infections including tuberculosis and typhoid fever agar to suppress commensal bacteria. The media used for this are
are commonly confused with melioidosis. The commonest clinical Ashdown’s Selective agar (ASA) or B. pseudomallei Selective Agar
presentation of the disease in northern Australia and Southeast Asia (BPSA)7,29. ASA was developed for clinical bacteriology use, but may
where the infection appears to be commonest is septicaemia with or inhibit the growth of some strains of B. pseudomallei, particularly those
without pneumonia (Table 1) 4. Other focal organ involvement is that are excessively mucoid. BPSA was developed to improve recovery
common either as a primary source of subsequent septicaemia or as a of mucoid strains without reducing recovery of the classic wrinkled
due to localisation following bloodstream spread. Meningoencephalitis, type. A laboratory discovery pathway has been developed for B.
pneumonia without septicaemia, osteomyelitis, septic arthritis, spinal pseudomallei10. This comprises three stages (Table 2): an initial screen
involvement, localised abscesses in almost any deep organ or superficial of easily performed tests, confirmatory phenotypic methods and finally,
soft tissue have all been described. The majority of severe infections definitive genotypic confirmation. Substrate utilisation panels are used
occur in patients with a contributory co-morbidity such as uncontrolled in many laboratories to confirm the identity of suspected B.
diabetes mellitus, chronic renal failure, alcoholic liver disease or pseudomallei6,16,25. These appear to perform well when there is an
chronic lung disease17 . Overwhelming septicaemia does occasionally expectation that the isolate is indeed B. pseudomallei, or when
occur in previously fit young adults. The subacute end of this disease evaluating a collection of isolates already identified by substrate
spectrum usually takes the form of localised superficial soft tissue utilisation. However, neither the manual nor the automated substrate
infection in patients with no associated co-morbidities15. Melioidosis utilisation panels used to identify unknown Gram negative bacilli from
can present for the first time after a prolonged pre-patent period or
relapse after initially adequate antibiotic therapy followed by a
Table 2
quiescent interval2,18. This capacity to develop into a subclinical form,
Laboratory criteria for confirmation of B. pseudomallei infection
due to sequestration of dormant bacteria within the body was first
recognised in veterans of the Viet Nam conflict22. A history of soil or
surface water exposure and percutaneous inoculation may help identify Definitive:
the patient at risk of melioidosis, but will be absent in a proportion of culture of a Gram negative bacillus from blood, other sterile fluid or
subsequently diagnosed cases5. sputum sample with the following features
Table 1 ALL of ..
Clinical presentations of melioidosis Oxidase positive
Gentamicin resistant
Commonest acute presentations Polymyxin (Colistin) resistant
Pneumonia
Pneumonia with septicaemia PLUS one or more of ..
Septicaemia B. pseudomallei agglutinating antibody positive
B. pseudomallei-specific PCR positive
Other presentations B. pseudomallei 16s DNA sequence positive
Soft tissue infection: cellulitis, fasciitis, skin abscess/ulcer
Bone and joint infection: osteomyelitis, septic arthritis Supportive, but not definitive:
Genitourinary: prostatic abscess
CNS infection: cerebral abscess, meningoencephalitis, Gram negative bacillus from blood, other sterile fluid or sputum
encephalomyelitis sample without any positive confirmatory tests in a clinical
Facial: suppurative parotitis setting consistent with melioidosis
Ocular infection: conjunctival ulcer, hypopyon, orbital cellulitis
Gram negative bacillus from blood, other sterile fluid or sputum
Incidental finding sample in a clinical setting consistent with melioidosis, with
asymptomatic seroconversion positive first line tests (oxidase +, GM/POLY R) a
contradictory bacterial identification panel (e.g. API, Vitek
etc) but awaiting definitive test
DIAGNOSTIC INVESTIGATIONS
A fourfold or greater rise in B. pseudomallei antibodies by IHA
Confirmation of a diagnosis of melioidosis depends heavily on the or ELISA in a clinical setting consistent with melioidosis
clinical microbiology laboratory, and specifically on recovering a B.
pseudomallei isolate by culture from blood, sputum, cerebrospinal fluid A single very high B. pseudomallei antibody titre in a clinical
or other bacteriology specimen15. The bacterial count in venous blood setting consistent with melioidosis
2
3. INGLIS, T.J.J.; ROLIM, D.B. & RODRIGUEZ, J.L.N. - Clinical guideline for diagnosis and management of melioidosis. Rev. Inst. Med. trop. S. Paulo, 48(1): 1-4, 2006.
blood cultures are fully reliable9,14. Where molecular tests are not Table 3
available, substrate utilisation panels should be used with caution after Antibiotic therapy for culture confirmed melioidosis
taking into account the results of simple preliminary tests such as Gram
stain, oxidase and antibiotic susceptibility pattern6,10. Alternatively, they Severe, acute melioidosis including septicaemia, with or without
can be used to supplement other identification tests, or they may be pneumonia, central nervous system infection and other invasive
used in reference laboratories as part of classical bacteriological forms of the disease:
identification procedures that rely on polyphasic determinative
bacteriological methods10. All suspected B. pseudomallei isolates should EITHER
be stored on agar slopes or in glycerol broth at -70 oC for future reference Ceftazidime (adult)
laboratory work, even when preliminary results suggest that the isolate 2-3 g or 40 mg/kg/dose every eight hours intravenously for 2-4
in question is another bacterial species. We still encounter occasional weeks
referred clinical isolates that have been identified as another bacterial PLUS
species and that subsequently prove to be B. pseudomallei. Moreover, Co-trimoxazole (Trimethoprim-Sulphamethoxazole)
our current discovery pathway will probably require amendment when 10/50 mg/kg (up to 320/1600 g) every 12 hours
the more recent PCR protocols have been evaluated. Isolates referred
for definitive identification and molecular typing should be transferred OR
to reference laboratories in accordance with current UN/IATA Meropenem
guidelines. International transfers must also comply with the respective 1 g or 25 mg/kg every eight hours intravenously for ≥ 2 weeks
national quarantine regulations.
Eradication phase
Serological evidence of infection can be obtained by indirect 1 Trimethoprim-Sulphamethoxazole 8/40 mg/kg every 12 hours for
haemagglutination assay (IHA)30, but seroconversion is unlikely to ≥ 12-20 weeks
occur early enough to affect treatment choices during the admission 2 Doxycycline 4 mg/kg/day plus Trimethoprim-Sulphamethoxazole
phase of a severe, acute infection. False negatives do occur and though 8/40 mg/kg every 12 hours for ≥ 12-20 weeks
ELISA-based or indirect immunofluorescent (IFAT) tests have improved 3 Chloramphenicol 40 mg/kg/day plus Doxycycline 4 mg/kg/day,
the sensitivity and specificity in some centres, they have not completely Trimethoprim-Sulphamethoxazole 8/40 mg/kg every 12 hours for
resolved this problem26. Seroconversion or a single high IHA titre (e.g. ≥ 12-20 weeks
> 160) in the absence of a positive culture is therefore regarded as
supportive rather than definitive evidence of melioidosis15. The level
of titre regarded as diagnostic will vary in different locations according melioidosis case cluster in Ceara, in which three of the four presumed
to local melioidosis epidemiology. cases succumbed to infection, illustrated these problems 20,21. No
bacteriological diagnosis was possible in the first case. The Gram negative
IMMEDIATE AND CONTINUATION THERAPY bacillus from blood culture in the second case didn’t survive long enough
for definitive identification by the state public health laboratory, and the
Clinical trials have shown a significant reduction in mortality by one surviving case had no positive culture but a delayed seroconversion
early intervention with a suitable intravenous antibiotic, and comparable by IHA. A definitive, culture-based diagnosis was only made in the third
results with other, newer agents. Ceftazidime was the first antibiotic case after several days of processing an unfamiliar Gram negative isolate
to produce clear improvements in mortality (Table 3)27. There are whose initial appearance resembled Yersinia pestis on the Gram stain.
theoretic reasons why a carbapenem should be used instead for severe This result came too late to prevent a fatal outcome, but did alter the
infections11, and both Imipenem and Meropenem have been shown to choice of antibiotic therapy for the one survivor. We believe that increased
be at least as good as Ceftazidime3,23. Supplementary antibiotic agents awareness of the varied clinical presentation of melioidosis and correct
may have a place in treating persistent bacteraemic infection, or choice of diagnostic methods will result in faster diagnosis and a better
reducing the risk of early relapse but it is not yet clear which agent is prognosis for those with acute, septicaemic disease. This must be matched
most suitable or when it should be introduced. Other measures that by enhanced clinical laboratory capability, including the development
may also be important for specific patients with severe, acute infection of a melioidosis reference laboratory. The capacity to deliver melioidosis
include correction of metabolic acidosis, ketosis, diabetic control and reference tests is under development in Ceara, where the majority of
oxygenation¹². All these factors are likely to assist phagocytic function recent cases have presented. Finally, effective antibiotic therapy is
and possibly reduce the risk of late relapse. There is a lack of consensus available for this potentially fatal infection. Use of the recommended
on exactly how long to continue intravenous antibiotics and what to regimes will reduce the mortality from this disease and help prevent its
continue for oral eradication therapy. These issues will only be resolved subsequent relapse.
by carefully planned clinical trials.
RESUMO
CONCLUSION
Recomendações clínicas para o diagnóstico e
Melioidosis presents a diagnostic challenge to both the physician tratamento da melioidose
and the diagnostic laboratory scientist. The poor sensitivity and speed
of current methods of laboratory diagnosis of melioidosis will continue Melioidose é uma infecção emergente no Brasil e em países
to frustrate the primary diagnostician for some time to come. The 2003 vizinhos da América do Sul. O amplo espectro de apresentação clínica
3
4. INGLIS, T.J.J.; ROLIM, D.B. & RODRIGUEZ, J.L.N. - Clinical guideline for diagnosis and management of melioidosis. Rev. Inst. Med. trop. S. Paulo, 48(1): 1-4, 2006.
inclui pneumonia adquirida na comunidade, septicemia, infecção do 13. KENNY, D.J.; RUSSELL, P.; ROGERS, D.; ELEY, S.M. & TITBALL, R.W. - In vitro
sistema nervoso central e infecção de partes moles de menor severidade. susceptibilities of Burkholderia mallei in comparison to those of other pathogenic
Burkholderia spp. Antimicrob. Agents Chemother., 43: 2773-2775, 1999.
O diagnóstico depende essencialmente da identificação microbiológica.
Burkholderia pseudomallei, a causa bacteriana da melioidose, é 14. KOH, T.H.; YONG NG, L.S.; FOON HO, J.L. et al. - Automated identification systems
facilmente cultivada em sangue, escarro e em outras amostras clínicas. and Burkholderia pseudomallei. J. clin. Microbiol., 41: 1809, 2003.
Entretanto, B. pseudomallei pode ser difícil de identificar com segurança
e também ser confundido com outras bactérias Gram negativas. Os 15. LEELARASAMEE, A. & BOVORNKITTI, S. - Melioidosis: review and update. Rev.
infect. Dis., 11: 413-425, 1989.
exames sorológicos podem dar suporte a um diagnóstico de melioidose,
mas não fornece um diagnóstico definitivo por si só. A realização de 16. LOWE, P.; ENGLER, C. & NORTON, R. - Comparison of automated and nonautomated
investigação laboratorial seqüenciada pode ajudar a reduzir o risco de system for identification of Burkholderia pseudomallei. J. clin. Microbiol., 40: 4625-
não reconhecer isolados incomuns de B. pseudomallei. O tratamento 4627, 2002.
antibiótico recomendado para infecção severa é Ceftazidima ou
17. MERIANOS, A.; PATEL, M.; LANE, M.J. et al. - The 1990-1991 outbreak of melioidosis
Meropenem endovenosos por várias semanas, seguido por um in the Northern Territory of Australia: epidemiology and environmental studies.
tratamento oral com uma combinação de Sulfametoxazol-Trimetopim Southeast Asian J. trop. Med. publ. Hlth, 24: 425-435, 1993.
e Doxiciclina por até 20 semanas. O uso consistente do diagnóstico
microbiológico e o tratamento rigoroso da infecção severa com 18. NGAUY, V.; LEMESHEV, Y.; SADKOWSKI, L. & CRAWFORD, G. - Cutaneous
antibióticos adequados nas duas etapas, aguda e de erradicação, melioidosis in a man who was taken as a prisoner of war by the Japanese during
World War II. J. clin. Microbiol., 43: 970-972, 2005.
contribuirão para a redução da mortalidade por melioidose.
19. ROLIM, D.; INGLIS, T.; SOUSA, A.Q. et al. - Melioidose no Estado do Ceará: estudo
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4