Clinical presentation and treatment of melioidosis in the head and neck region.

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Clinical presentation and treatment of melioidosis in the head and neck region.

J Laryngol Otol. 2018 Sep 05;:1-5

Authors: Mahawerawat K, Kasemsiri P

Abstract
BACKGROUND: Although melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.
OBJECTIVES: To report the clinical presentation and management of melioidosis in the head and neck.
METHOD: A retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.
RESULTS: Medical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35-88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47-98.80).
CONCLUSION: Careful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.

PMID: 30180912 [PubMed - as supplied by publisher]

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