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A first report of pulmonary melioidosis in Cambodia.
Trans R Soc Trop Med Hyg. 2008 Dec; 102 Suppl 1:S21-5.TR

Abstract

Melioidosis has never been officially reported from Cambodia. Here we report two cases, a 58-year-old male (case 1) and a 49-year-old female (case 2) who presented with respiratory illnesses featuring multiple lung abscesses. The sputum culture of both patients, taken in the framework of a laboratory-based study on aetiologies of (sub-)acute respiratory infections among hospitalized patients in southern Cambodia, grew Burkholderia pseudomallei. The most striking aspect of these case stories was the extent of the delays in diagnosis. Presenting with a 1-month history of respiratory symptoms, case 1 was first suspected of tuberculosis (TB) infection, and then misdiagnosed as 'metastatic lung cancer' in Phnom Penh, Cambodia. Case 2 suffered from pulmonary infections for >10 years, during which time she was treated for TB four times. Neither patient ever produced acid-fast-bacilli (AFB)-positive sputum. Following our laboratory confirmation, the patients were traced for re-admission. Under the 'classical' trimethoprim sulphamethoxazole, chloramphenicol and doxycycline treatment, their clinical status improved considerably within 2 weeks. The two study cases illustrate issues relating to the misdiagnosis of melioidosis in Cambodia; an unfamiliarity of clinicians with the disease, which is associated with a high prevalence of TB. Therefore, a heightened awareness of melioidosis among clinicians would have a substantial impact on public health as the non-septicaemic form of the disease is potentially treatable with antibiotics that are available in Cambodian public hospitals.

Authors+Show Affiliations

Swiss Red Cross, Takeo, Cambodia. overtoom.r@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19121680

Citation

Overtoom, Rob, et al. "A First Report of Pulmonary Melioidosis in Cambodia." Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 102 Suppl 1, 2008, pp. S21-5.
Overtoom R, Khieu V, Hem S, et al. A first report of pulmonary melioidosis in Cambodia. Trans R Soc Trop Med Hyg. 2008;102 Suppl 1:S21-5.
Overtoom, R., Khieu, V., Hem, S., Cavailler, P., Te, V., Chan, S., Lau, P., Guillard, B., & Vong, S. (2008). A first report of pulmonary melioidosis in Cambodia. Transactions of the Royal Society of Tropical Medicine and Hygiene, 102 Suppl 1, S21-5. https://doi.org/10.1016/S0035-9203(08)70007-5
Overtoom R, et al. A First Report of Pulmonary Melioidosis in Cambodia. Trans R Soc Trop Med Hyg. 2008;102 Suppl 1:S21-5. PubMed PMID: 19121680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A first report of pulmonary melioidosis in Cambodia. AU - Overtoom,Rob, AU - Khieu,Virak, AU - Hem,Sopheak, AU - Cavailler,Philippe, AU - Te,Vantha, AU - Chan,Sarin, AU - Lau,Phea, AU - Guillard,Bertrand, AU - Vong,Sirenda, PY - 2009/1/6/entrez PY - 2009/1/16/pubmed PY - 2009/11/11/medline SP - S21 EP - 5 JF - Transactions of the Royal Society of Tropical Medicine and Hygiene JO - Trans R Soc Trop Med Hyg VL - 102 Suppl 1 N2 - Melioidosis has never been officially reported from Cambodia. Here we report two cases, a 58-year-old male (case 1) and a 49-year-old female (case 2) who presented with respiratory illnesses featuring multiple lung abscesses. The sputum culture of both patients, taken in the framework of a laboratory-based study on aetiologies of (sub-)acute respiratory infections among hospitalized patients in southern Cambodia, grew Burkholderia pseudomallei. The most striking aspect of these case stories was the extent of the delays in diagnosis. Presenting with a 1-month history of respiratory symptoms, case 1 was first suspected of tuberculosis (TB) infection, and then misdiagnosed as 'metastatic lung cancer' in Phnom Penh, Cambodia. Case 2 suffered from pulmonary infections for >10 years, during which time she was treated for TB four times. Neither patient ever produced acid-fast-bacilli (AFB)-positive sputum. Following our laboratory confirmation, the patients were traced for re-admission. Under the 'classical' trimethoprim sulphamethoxazole, chloramphenicol and doxycycline treatment, their clinical status improved considerably within 2 weeks. The two study cases illustrate issues relating to the misdiagnosis of melioidosis in Cambodia; an unfamiliarity of clinicians with the disease, which is associated with a high prevalence of TB. Therefore, a heightened awareness of melioidosis among clinicians would have a substantial impact on public health as the non-septicaemic form of the disease is potentially treatable with antibiotics that are available in Cambodian public hospitals. SN - 1878-3503 UR - https://www.unboundmedicine.com/medline/citation/19121680/A_first_report_of_pulmonary_melioidosis_in_Cambodia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0035-9203(08)70007-5 DB - PRIME DP - Unbound Medicine ER -