Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent

J Infect Dev Ctries. 2017 Jan 30;11(1):28-33. doi: 10.3855/jidc.7612.

Abstract

Introduction: Melioidosis involving bone, joints, and soft tissue is rare and reported usually following dissemination of disease from infection elsewhere in the body; to a lesser degree, it can also be reported as the primary manifestation of melioidosis.

Methodology: The orthopedic registry at Hospital University Sains Malaysia from 2008 until 2014 was retrospectively reviewed and was followed by molecular typing of Burkholderia pseudomallei.

Results: Out of 20 cases identified, 19 patients were confirmed to have osteoarticular and/or soft-tissue melioidosis. The majority of the patients were males (84%), and 16 patients had underlying diabetes mellitus with no significant estimated risk with the disease outcomes. Bacterial genotype was not associated with the disease as a risk. Death was a significant outcome in patients with bacteremic infections (p = 0.044).

Conclusion: Patients with lung or skin melioidosis require careful treatment follow-up to minimize the chance for secondary osteoarticular infection. Human risk factors remain the leading predisposing factors for melioidosis. Early laboratory and clinical diagnosis and acute-phase treatment can decrease morbidity and mortality.

MeSH terms

  • Adolescent
  • Adult
  • Burkholderia pseudomallei / classification
  • Burkholderia pseudomallei / genetics
  • Burkholderia pseudomallei / isolation & purification*
  • Child
  • Diabetes Complications
  • Female
  • Humans
  • Malaysia / epidemiology
  • Male
  • Melioidosis / epidemiology*
  • Melioidosis / microbiology
  • Melioidosis / pathology*
  • Middle Aged
  • Molecular Typing
  • Osteoarthritis / epidemiology*
  • Osteoarthritis / microbiology
  • Osteoarthritis / pathology*
  • Retrospective Studies
  • Risk Factors
  • Soft Tissue Infections / epidemiology*
  • Soft Tissue Infections / microbiology
  • Soft Tissue Infections / pathology*
  • Survival Analysis
  • Young Adult