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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Melioidosis is an emerging infectious disease in India acquired through percutaneous inoculation or contaminated water. Known risk factors include diabetes mellitus, renal failure, cirrhosis, and malignancy. Melioidosis presents with a febrile illness, with protean manifestations ranging from septicemia to localized abscess formation. We present the case of a 42-year-old male from a non-endemic region who presented with fever of 2 months duration, sepsis, persistent pneumonia, right hip joint pain and hepatic and splenic abscesses. Aspiration of the joint and soft tissue fluid collection and subsequent culture yielded gram negative bacilli identified as Burkholderia pseudomallei. The epidemiology, clinical features, and laboratory diagnosis of this rare infection and its treatment is reviewed.
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PMID:Melioidosis. 1905 12

Melioidosis is sporadically reported from various parts of India. We present a case series from south India, highlighting the varied manifestations of the disease. Seven cases of culture-proven melioidosis are presented in whom Burkholderia pseudomallei were isolated from aspirate or blood. Melioidosis had a varied presentation involving multiple abscesses in the soft tissues, liver, spleen, mediastinum and the subdural space. It presented as either acute fulminant sepsis or followed a chronic indolent course, mimicking tuberculosis. Most cases had predisposing risk factors such as diabetes and chronic alcoholism.
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PMID:Melioidosis--a case series from south India. 1912 79

Melioidosis, an infection due to the environmental bacterium Burkholderia pseudomallei, is endemic to Southeast Asia and northern Australia, with cases strongly correlated with the monsoonal wet season. We hypothesized that seasonal variation in the mode of acquisition, informed by traditional knowledge, would result in variations in disease characteristics as well as disease incidence. We explored the seasonal variation in acute, culture-confirmed melioidosis using local Aboriginal definitions of seasons in presentations to the Royal Darwin Hospital, the referral centre for the Top End of the Northern Territory, Australia. In 387 patients, we observed an increased proportion of patients with pneumonia (60%) and severe sepsis (25%) associated with presentations in the wet seasons Gunumeleng (October-December) and Gudjewg (January-March) compared with the drier seasons Wurrgeng (June August) and Gurrung (August-October) (pneumonia 26%, severe sepsis 13%). This observation supports the hypothesis that in the wet seasons there may be changes in the mode and/or magnitude of exposure to B. pseudomallei, with a shift from percutaneous inoculation to aerosol inhalation, for instance.
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PMID:Melioidosis and Aboriginal seasons in northern Australia. 1912 81

Burkholderia pseudomallei is the causative agent of melioidosis, a fatal disease that is endemic to Southeast Asia and northern Australia. The clinical manifestations of melioidosis may range from an acute pneumonia or acute septicemia, to chronic and latent infections. B. pseudomallei is inherently resistant to a number of antibiotics, and even with aggressive antibiotic therapy, the mortality rate remains high, and the incidence of relapse is common. The resistance of this organism to a number of antibiotics has created a need for the development of other therapeutic strategies, including the identification of novel therapeutic targets. B. pseudomallei has been shown to produce a number of capsular polysaccharides, one of which has been shown to contribute to the virulence of the organism. The structures of these polysaccharides have been determined and the genes encoding for the biosynthesis of one of the capsular polysaccharides (CPS I) have been identified. Analysis of the genome sequence of this organism has revealed the presence of three other capsule gene clusters that may encode for the chemical structures previously identified. Since one of the capsules produced by B. pseudomallei has been shown to be important in virulence, the genes encoding for the proteins responsible for its biosynthesis may be considered as potential targets.
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PMID:Genetics and function of the capsules of Burkholderia pseudomallei and their potential as therapeutic targets. 1920 30

With globalization, foreign patients are frequently encountered at the clinical practice in Korea. As the number of migrant workers from Southeast Asia has been notably rising since the late 1990's, unfamiliar tropical infectious diseases that they bring out, may give great challenges to the routine clinical practice in Korea. Melioidosis is a community-acquired infection caused by a gram-negative bacillus, Burkholderia pseudomallei. It has been endemic in Southeast Asia and Northern Australia, where B. pseudomallei is a soil saprophyte and invades the host through inoculation or inhalation. It frequently presents as an acute septicemia with a high mortality rate of 40%, mainly in patients with chronic underlying diseases, such as diabetes mellitus. Recently, we encountered a case of fatal disseminated melioidosis in a migrant worker from Thailand. We suggest an importance of melioidosis as a cause of community-acquired sepsis in migrant workers from Southeast Asia.
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PMID:[A case of disseminated melioidosis in a migrant worker from Thailand]. 1941 81

Human melioidosis caused by Burkholderia pseudomallei is a severe septic disease that is associated with high mortality, even under appropriate antibiotic treatment. The therapeutic effects of low-dose hydrocortisone plus ceftazidime, and of ceftazidime alone, have recently been investigated in the treatment of acute, severe sepsis caused by B. pseudomallei, both in normal BALB/c mice and in BALB/c mice with streptozotocin-induced diabetes. The mice were infected and then treated intravenously, from day 1 or day 2 post-infection, with saline (as a control, given twice daily for 10 days), low-dose hydrocortisone (given in twice-daily doses of 5 mg/kg, for 5 days) plus ceftazidime (given in twice-daily doses of 1200 mg/kg, for 10 days), or the same doses of ceftazidime alone. Although the infected, untreated mice all died within 14 days, almost all of the treated animals were still alive at the end of the follow-up, 30 days post-infection. The addition of the steroid appeared to have no benefit, with bacterial loads and plasma concentrations of tumour necrosis factor, aspartate aminotransferase, alanine aminotransferase and creatinine decreasing similarly in all the treated groups. The infected diabetic mice given hydrocortisone-ceftazidime from day 1 (but not those given just ceftazidime from day 1) showed an increase in their blood glucose concentrations. When infected mice were treated with the low-dose steroid and lower doses of the antibiotic (in twice-daily doses of 120-600 mg/kg), the steroid not only offered no apparent benefit but seemed to reduce survival. It therefore appears that low-dose hydrocortisone, as an adjunct to antibiotic treatment, does not provide benefit in the treatment of murine melioidosis and may have negative effects on human cases of the disease who have diabetes mellitus.
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PMID:Use of a low-dose steroid as an adjunct in the treatment, in mice, of severe sepsis caused by Burkholderia pseudomallei. 1982 85

Changes in the microbiological characteristics of sepsis have been observed over the past few decades. Infections caused by Gram-positive bacteria and fungi have become more common in some areas, possibly as a consequence of the increased use of intravascular and other medical devices, an increase in invasive procedures and the use of immunosuppressant agents. As observed with other infections there has been an emergence of multiresistant Gram-positive and Gram-negative pathogens. Most of the published data come from wealthy countries in temperate climates, and although many of the same changes have been observed in developing countries, there are important regional differences in the microbiology of sepsis. For example, typhoidal salmonellae remain the most important cause of bloodstream infection in parts of South Asia, nontyphoidal salmonella infections are predominant in parts of sub-Saharan Africa and melioidosis is important in endemic areas. The microbiological pattern of sepsis has also been influenced by the rise in prevalence of HIV infection in many regions.
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PMID:Microbiological patterns in sepsis: what happened in the last 20 years? 1993 19

Melioidosis is an infection affecting both human and animal health. The causative agent is Burkholderia pseudomallei, a Gram-negative soil bacterium. Melioidosis is endemic in tropical areas of Southeast Asia and Northern Australia, and sporadic in many other countries. Clinical presentation is variable ranging from acute septicemia, isolated pulmonary infection, or chronic granulomatous lesions to asymptomatic forms with positive serology. There is no vaccine and treatment is difficult because B. pseudomallei is resistant to a wide range of antibiotics. Relapses are common. B. pseudomallei is listed as a biological risk class 3 and considered as a potential bioterrorism agent due to its high virulence by inhalation, to the difficulty of treatment, and to the lack of vaccine.
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PMID:[Melioidosis: an emerging tropical disease]. 2002 69

Urokinase receptor (urokinase-type plasminogen activator receptor [uPAR], CD87), a GPI-anchored protein, is considered to play an important role in inflammation and fibrinolysis. The Gram-negative bacterium Burkholderia pseudomallei is able to survive and replicate within leukocytes and causes melioidosis, an important cause of pneumonia-derived community-acquired sepsis in Southeast Asia. In this study, we investigated the expression and function of uPAR both in patients with septic melioidosis and in a murine model of experimental melioidosis. uPAR mRNA and surface expression was increased in patients with septic melioidosis in/on both peripheral blood monocytes and granulocytes as well as in the pulmonary compartment during experimental pneumonia-derived melioidosis in mice. uPAR-deficient mice intranasally infected with B. pseudomallei showed an enhanced growth and dissemination of B. pseudomallei when compared with wild-type mice, corresponding with increased pulmonary and hepatic inflammation. uPAR knockout mice demonstrated significantly reduced neutrophil migration toward the pulmonary compartment after inoculation with B. pseudomallei. Further in vitro experiments showed that uPAR-deficient macrophages and granulocytes display a markedly impaired phagocytosis of B. pseudomallei. Additional studies showed that uPAR deficiency did not influence hemostatic and fibrinolytic responses during severe melioidosis. These data suggest that uPAR is crucially involved in the host defense against sepsis caused by B. pseudomallei by facilitating the migration of neutrophils toward the primary site of infection and subsequently facilitating the phagocytosis of B. pseudomallei.
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PMID:Urokinase receptor is necessary for bacterial defense against pneumonia-derived septic melioidosis by facilitating phagocytosis. 2014 64

Melioidosis is an emerging infectious disease in our country. It is an important cause of community-acquired 'sepsis syndrome' particularly in patients with underlying immunosuppression which often goes undetected due to lack of awareness resulting in high fatalities. Here we report a case of septicaemic melioidosis in a diabetic patient.
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PMID:Septicaemic melioidosis. 2065 60


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