Epidemiology and clinical spectrum of melioidosis: Analysis of cases from a tertiary care centre in southern Tamil Nadu

Natl Med J India. 2024 Jan-Feb;37(1):22-25. doi: 10.25259/NMJI_402_2022.

Abstract

Background We studied the clinical features and treatment outcome of patients with melioidosis in our hospital. Methods We did this retrospective observational chart review over a period of 7 years between December 2014 and February 2022. Results There were 59 cases and 23 deaths attributable to melioidosis over the study period. The age range was 5 to 74 years and 48 (81.3%) were men. The comorbid conditions included diabetes mellitus (68%), alcoholism (11.8%), pulmonary tuberculosis (6.7%) and chronic kidney disease (5%). Over three-fourths of patients (78%) presented during the rainy season (June to December) and were acute presentations (44 [75%]). The most common sites were liver and spleen, followed by the musculoskeletal system, skin, soft tissues, lungs and brain. Of the 21 (36%) patients with septic shock, 16 (76%) died. On the contrary, of 38 (64%) patients without septic shock, only 11% died. Of the 27 (47%) admitted to ICU, 11 (41%) died. In ICU, 18 (67%) were ventilated. Of the 23 (39%) deaths overall, median time from admission to death was 4 days. There were no relapses in the 42% patients followed up for 2-6 months. Conclusions The epidemiology of melioidosis is similar to other endemic areas with preponderance of men. There was a temporal association with the monsoon season and a higher number of acute cases. The differences included a higher proportion of deep visceral abscesses and musculo-skeletal involvement compared to lung involvement.

Publication types

  • Observational Study
  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Comorbidity
  • Female
  • Humans
  • India / epidemiology
  • Male
  • Melioidosis* / diagnosis
  • Melioidosis* / epidemiology
  • Melioidosis* / mortality
  • Middle Aged
  • Retrospective Studies
  • Seasons
  • Shock, Septic / epidemiology
  • Shock, Septic / microbiology
  • Shock, Septic / mortality
  • Tertiary Care Centers* / statistics & numerical data
  • Young Adult