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Dural sinus thrombosis in melioidosis: the first case report.
J Med Assoc Thai. 2006 Feb; 89(2):242-7.JM

Abstract

Melioidosis which is infection with Burkholderia pseudomallei, is an important cause of sepsis in India, southeast Asia and northern Australia. Mortality is high and treatment is problematic. Neurological melioidosis is unusual but meningoencephalitis, encephalomyelitis and brain microabscess can occur Dural sinus thrombosis is not an uncommon cerebrovascular disorder with various etiologies. Hypercoagulable state, pregnancy, dehydration, certain blood dyscrasia and contraceptive pills are common causes however meningitis and local head & neck infections may lead to this condition. Dural sinus thrombosis complicating septicemic melioidosis has never been reported. The authors report a 42-year-old Thai man suffering from septicemic melioidosis with dural sinus thrombosis. He had high fever, headache, left hemiparesis, focal seizure and increased intracranial pressure. Diabetes and mild alcoholic cirrhosis were diagnosed in this admission. CT scan, MRI brain and MRV revealed superior saggital sinus thrombosis with complicating venous infarction over right posterior parietal lobe. Hemoculture demonstrated Burkholderia pseudomallei and CSF was acellular Investigations for causes of dural sinus thrombosis were all negative. This patient gradually improved after treatment with ceftazidime, antiepileptic drug and heparin without clinical recurrence. Neuromelioidosis is a rare syndrome that may present as brain abscess, encephalitis or meningoencephalitis. The authors report dural sinus thrombosis associated with septicemic melioidosis. The authors' hypothesis of venous thrombosis in the presented case is sepsis induced hypercoagulable state. Physicians should be aware of cerebral venous thrombosis in case of suspicious melioidosis with neurological involvement. Prompt treatment with intravenous heparin and antibiotic is potentially effective.

Authors+Show Affiliations

Division of Neurology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16579013

Citation

Niyasom, Suchada, et al. "Dural Sinus Thrombosis in Melioidosis: the First Case Report." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 89, no. 2, 2006, pp. 242-7.
Niyasom S, Sithinamsuwan P, Udommongkol C, et al. Dural sinus thrombosis in melioidosis: the first case report. J Med Assoc Thai. 2006;89(2):242-7.
Niyasom, S., Sithinamsuwan, P., Udommongkol, C., & Suwantamee, J. (2006). Dural sinus thrombosis in melioidosis: the first case report. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 89(2), 242-7.
Niyasom S, et al. Dural Sinus Thrombosis in Melioidosis: the First Case Report. J Med Assoc Thai. 2006;89(2):242-7. PubMed PMID: 16579013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dural sinus thrombosis in melioidosis: the first case report. AU - Niyasom,Suchada, AU - Sithinamsuwan,Pasiri, AU - Udommongkol,Chesda, AU - Suwantamee,Jithanorm, PY - 2006/4/4/pubmed PY - 2006/4/28/medline PY - 2006/4/4/entrez SP - 242 EP - 7 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 89 IS - 2 N2 - Melioidosis which is infection with Burkholderia pseudomallei, is an important cause of sepsis in India, southeast Asia and northern Australia. Mortality is high and treatment is problematic. Neurological melioidosis is unusual but meningoencephalitis, encephalomyelitis and brain microabscess can occur Dural sinus thrombosis is not an uncommon cerebrovascular disorder with various etiologies. Hypercoagulable state, pregnancy, dehydration, certain blood dyscrasia and contraceptive pills are common causes however meningitis and local head & neck infections may lead to this condition. Dural sinus thrombosis complicating septicemic melioidosis has never been reported. The authors report a 42-year-old Thai man suffering from septicemic melioidosis with dural sinus thrombosis. He had high fever, headache, left hemiparesis, focal seizure and increased intracranial pressure. Diabetes and mild alcoholic cirrhosis were diagnosed in this admission. CT scan, MRI brain and MRV revealed superior saggital sinus thrombosis with complicating venous infarction over right posterior parietal lobe. Hemoculture demonstrated Burkholderia pseudomallei and CSF was acellular Investigations for causes of dural sinus thrombosis were all negative. This patient gradually improved after treatment with ceftazidime, antiepileptic drug and heparin without clinical recurrence. Neuromelioidosis is a rare syndrome that may present as brain abscess, encephalitis or meningoencephalitis. The authors report dural sinus thrombosis associated with septicemic melioidosis. The authors' hypothesis of venous thrombosis in the presented case is sepsis induced hypercoagulable state. Physicians should be aware of cerebral venous thrombosis in case of suspicious melioidosis with neurological involvement. Prompt treatment with intravenous heparin and antibiotic is potentially effective. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/16579013/Dural_sinus_thrombosis_in_melioidosis:_the_first_case_report_ L2 - http://www.diseaseinfosearch.org/result/7087 DB - PRIME DP - Unbound Medicine ER -