Cutaneous melioidosis in the tropical top end of Australia: a prospective study and review of the literature.

Katherine B Gibney, Allen C Cheng, Bart J Currie
Author Information
  1. Katherine B Gibney: Infectious Diseases Unit and Northern Territory Clinical School, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

Abstract

BACKGROUND: Burkholderia pseudomallei is endemic in northern Australia, and melioidosis is a common cause of sepsis in the region.
METHODS: We summarized the cutaneous manifestations of melioidosis from a prospective cohort of 486 patients with culture-confirmed melioidosis in northern Australia, and we compared those who had primary skin melioidosis with those who had other forms of melioidosis.
RESULTS: Primary skin melioidosis occurred in 58 patients (12%). Secondary skin melioidosis--multiple pustules from hematogenous spread--was present in 10 patients (2%). Patients with primary skin melioidosis were more likely to have chronic presentations (duration, >or=2 months). On multivariate analysis, patients with primary cutaneous melioidosis were more likely to be children aged CONCLUSION: In our cohort, patients with primary skin melioidosis were younger, had fewer underlying medical conditions, and had better outcomes than did those with other forms of melioidosis. There may be a role for exclusive oral antibiotic therapy for some cases of primary skin melioidosis.

MeSH Term

Administration, Oral
Adolescent
Adult
Age Factors
Anti-Bacterial Agents
Australia
Burkholderia pseudomallei
Child
Child, Preschool
Female
Humans
Male
Melioidosis
Middle Aged
Occupational Exposure
Prospective Studies
Skin Diseases, Bacterial
Treatment Outcome
Young Adult

Chemicals

Anti-Bacterial Agents

Word Cloud

Created with Highcharts 10.0.0melioidosispatientsskinprimary0adjustedoddsratio95%CI1likelypseudomalleinorthernAustraliasepsiscutaneousprospectivecohortforms582%chronic326oraltherapyBACKGROUND:BurkholderiaendemiccommoncauseregionMETHODS:summarizedmanifestations486culture-confirmedcomparedRESULTS:Primaryoccurred12%Secondarymelioidosis--multiplepustuleshematogenousspread--waspresent10Patientspresentationsduration>or=2monthsmultivariateanalysischildrenagedyears850confidenceinterval[CI]24-2228historyoccupationalexposureB1256-625lesstypicalriskfactors--includingdiabetes12-056excessivealcoholintake4522-090lungdisease10-067patientbacteremicnoneseverediedFour7%presentingdisseminatedexperiencedrelapseNine16%curedregimenantibioticsalonerecoveredCONCLUSION:youngerfewerunderlyingmedicalconditionsbetteroutcomesmayroleexclusiveantibioticcasesCutaneoustropicaltopendAustralia:studyreviewliterature

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