Outcome of pediatric melioidosis in Mukdahan hospital

Abstract

Background : Melioidosis is an important fatal medical problem in northeast Thailand. Despite of the improvement of the medical technology, the incidence and mortality rate is still increasing. There were no studies about pediatric melioidosis in Mukdahan Province. We, therefore, investigated the characteristics and treatment outcome of pediatric melioidosis in Mukdahan Hospital Method : This is a retrospective study of the Burkholderia pseudomallei cultured positive 71 patients, younger than 15 years, who were admitted in Mukdahan hospital between 1 October 2011 to 30 September 2018. All demographic and clinical data were analyzed. Results : Most of the pediatric patients were male (62%), age between 1-5 years (57.70%). Rainy season was the most common season of infection (74.60%). Common clinical presentation was fever with head-neck swelling (39.40%). The investigation for diagnosis of melioidosis were pus culture (67.61%) and hemoculture (26.76%). According to types of melioidosis infection, localized melioidosis was the most common (73.20%), followed by non-disseminated septicemia (25.40%) and disseminated septicemic melioidosis (1.40%). The respective site of localized infection for skin/soft tissue abscess, parotid abscess and pneumonia were 44.23%, 42.31% and 7.70%. Therapeutic options included ceftazidime injection (25.40%), meropenem injection (12.70%) and surgical treatment combined with ceftazidime injection (57.70%). Most of the patients were treated without complication (70.40%) and had clinical improvement (77.47%). The overall mortality rate was 4.22%. Conclusion : Pediatric melioidosis in Mukdahan Province has a unique characteristic and treatment outcome is satisfactory. However, The mortality rate in Non-Disseminated septicemia melioidosis group with unknown infection site is high (66.66%).There is the need of more studies to characterized non-disseminated melioidosis with unknown infection site patients.