Publication: Rheumatological manifestations in patients with melioidosis
Issued Date
2008-07-01
Resource Type
ISSN
01251562
Other identifier(s)
2-s2.0-49749136972
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Mahidol University
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SCOPUS
Bibliographic Citation
Southeast Asian Journal of Tropical Medicine and Public Health. Vol.39, No.4 (2008), 649-655
Suggested Citation
P. Teparrakkul, J. J. Tsai, W. Chierakul, J. F. Gerstenmaier, T. Wacharaprechasgu, W. Piyaphanee, D. Limmathurotsakul, W. Chaowagul, N. P. Day, S. J. Peacock Rheumatological manifestations in patients with melioidosis. Southeast Asian Journal of Tropical Medicine and Public Health. Vol.39, No.4 (2008), 649-655. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/19626
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Title
Rheumatological manifestations in patients with melioidosis
Abstract
Melioidosis, an infection caused by the bacterium Burkholderia pseudomallei, has a wide range of clinical manifestations. Here, we describe rheumatological melioidosis (involving one or more of joint, bone or muscle), and compare features and outcome with patients without rheumatological involvement. A retrospective study of patients with culture-confirmed melioidosis admitted to Sappasithiprasong Hospital, Ubon Ratchathani during 2002 and 2005 identified 679 patients with melioidosis, of whom 98 (14.4%) had rheumatological melioidosis involving joint (n=52), bone (n = 5), or muscle (n = 12), or a combination of these (n=29). Females were over-represented in the rheumatological group, and diabetes and thalassemia were independent risk factors for rheumatological involvement (OR; 2.49 and 9.56, respectively). Patients with rheumatological involvement had a more chronic course, as reflected by a longer fever clearance time (13 vs 7 days, p = 0.06) and hospitalization (22 vs 14 days, p < 0.001), but lower mortality (28% vs 44%, p = 0.005). Patients with signs and symptoms of septic arthritis for longer than 2 weeks were more likely to have extensive infection of adjacent bone and muscle, particularly in diabetic patients. Surgical intervention was associated with a survival benefit, bur not a shortening of the course of infection.