Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep 13;11(9):e0005923.
doi: 10.1371/journal.pntd.0005923. eCollection 2017 Sep.

Melioidosis in lower provincial Cambodia: A case series from a prospective study of sepsis in Takeo Province

Kevin L Schully  1 , Catherine M Berjohn  2 , Angela M Prouty  2 , Amitha Fitkariwala  2 , Tin Som  2 , Darith Sieng  2 , Michael J Gregory  1 , Andrew Vaughn  2 , Sim Kheng  3 , Vantha Te  4 , Christopher A Duplessis  1 , James V Lawler  1 , Danielle V Clark  1
Affiliations

Melioidosis in lower provincial Cambodia: A case series from a prospective study of sepsis in Takeo Province

Kevin L Schully et al. PLoS Negl Trop Dis. .

Abstract

Melioidosis is a severe infectious disease caused by the gram-negative soil bacterium Burkholderia pseudomallei. Melioidosis is well known to be a major cause of morbidity and mortality in Southeast Asia, particularly in Thailand. However, melioidosis remains underreported in surrounding areas such as Cambodia. We report a case series of melioidosis in seven patients from Takeo Province, Cambodia. The patients, aged 24-65 years, were enrolled from May 2014 to May 2015 during a one year prospective study of sepsis at Takeo Provincial Hospital. They presented with fever, rigors, dyspnea, fatigue, diaphoresis, productive cough, and skin abscesses. Six of the seven patients were also hyponatremic. B. pseudomallei was cultured from the blood of six patients and the sputum of one patient. In this manuscript, we provide a detailed description of the clinical presentation, case management and laboratory confirmation of B. pseudomallei, as well as discuss the difficulties of identifying and treating melioidosis in low resource settings.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study site.
We used DIVA-GIS (http://diva-gis.org/) to create a map of Cambodia and surrounding areas. The red H indicates Takeo Provincial Hospital, the study site for this work. Dots indicate the location of the home village of seven melioidosis patients. Map is reflective of Cambodian Provincial borders during the time of patient enrollment.
Fig 2
Fig 2. Chest radiography.
Plain films taken on hospital day 1 (patient 2, 4, 7a) and hospital day 9 (patient 7-b).
See this image and copyright information in PMC

References

    1. Wiersinga WJ, Currie BJ, Peacock SJ. Melioidosis. N Engl J Med. 2012;367(11):1035–44. Epub 2012/09/14. doi: 10.1056/NEJMra1204699 - DOI - PubMed
    1. Limmathurotsakul D, Golding N, Dance DA, Messina JP, Pigott DM, Moyes CL, et al. Predicted global distribution of and burden of melioidosis. Nature microbiology. 2016;1(1). - PubMed
    1. Chaowagul W, White NJ, Dance DA, Wattanagoon Y, Naigowit P, Davis TM, et al. Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. J Infect Dis. 1989;159(5):890–9. Epub 1989/05/01. - PubMed
    1. Limmathurotsakul D, Wongratanacheewin S, Teerawattanasook N, Wongsuvan G, Chaisuksant S, Chetchotisakd P, et al. Increasing incidence of human melioidosis in Northeast Thailand. Am J Trop Med Hyg. 2010;82(6):1113–7. Epub 2010/06/04. doi: 10.4269/ajtmh.2010.10-0038 - DOI - PMC - PubMed
    1. Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev. 2005;18(2):383–416. Epub 2005/04/16. doi: 10.1128/CMR.18.2.383-416.2005 - DOI - PMC - PubMed