Clinical guideline for diagnosis and management of melioidosis
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/30959 |
Resumo: | Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates. Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two stages; acute and eradication, will contribute to a reduction in mortality from melioidosis. |
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Clinical guideline for diagnosis and management of melioidosis Recomendações clínicas para o diagnóstico e tratamento da melioidose MelioidosisClinical guidelineDiagnosisAntibioticsBurkholderia pseudomallei Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates. Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two stages; acute and eradication, will contribute to a reduction in mortality from melioidosis. Melioidose é uma infecção emergente no Brasil e em países vizinhos da América do Sul. O amplo espectro de apresentação clínica inclui pneumonia adquirida na comunidade, septicemia, infecção do sistema nervoso central e infecção de partes moles de menor severidade. O diagnóstico depende essencialmente da identificação microbiológica. Burkholderia pseudomallei, a causa bacteriana da melioidose, é facilmente cultivada em sangue, escarro e em outras amostras clínicas. Entretanto, B. pseudomallei pode ser difícil de identificar com segurança e também ser confundido com outras bactérias Gram negativas. Os exames sorológicos podem dar suporte a um diagnóstico de melioidose, mas não fornece um diagnóstico definitivo por si só. A realização de investigação laboratorial seqüenciada pode ajudar a reduzir o risco de não reconhecer isolados incomuns de B. pseudomallei. O tratamento antibiótico recomendado para infecção severa é Ceftazidima ou Meropenem endovenosos por várias semanas, seguido por um tratamento oral com uma combinação de Sulfametoxazol-Trimetopim e Doxiciclina por até 20 semanas. O uso consistente do diagnóstico microbiológico e o tratamento rigoroso da infecção severa com antibióticos adequados nas duas etapas, aguda e de erradicação, contribuirão para a redução da mortalidade por melioidose. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2006-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30959Revista do Instituto de Medicina Tropical de São Paulo; Vol. 48 No. 1 (2006); 1-4 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 48 Núm. 1 (2006); 1-4 Revista do Instituto de Medicina Tropical de São Paulo; v. 48 n. 1 (2006); 1-4 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30959/32843Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessInglis, Timothy J.J.Rolim, Dionne B.Rodriguez, Jorge L.N.2015-07-22T18:59:08Zoai:revistas.usp.br:article/30959Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:40.785657Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Clinical guideline for diagnosis and management of melioidosis Recomendações clínicas para o diagnóstico e tratamento da melioidose |
title |
Clinical guideline for diagnosis and management of melioidosis |
spellingShingle |
Clinical guideline for diagnosis and management of melioidosis Inglis, Timothy J.J. Melioidosis Clinical guideline Diagnosis Antibiotics Burkholderia pseudomallei |
title_short |
Clinical guideline for diagnosis and management of melioidosis |
title_full |
Clinical guideline for diagnosis and management of melioidosis |
title_fullStr |
Clinical guideline for diagnosis and management of melioidosis |
title_full_unstemmed |
Clinical guideline for diagnosis and management of melioidosis |
title_sort |
Clinical guideline for diagnosis and management of melioidosis |
author |
Inglis, Timothy J.J. |
author_facet |
Inglis, Timothy J.J. Rolim, Dionne B. Rodriguez, Jorge L.N. |
author_role |
author |
author2 |
Rolim, Dionne B. Rodriguez, Jorge L.N. |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Inglis, Timothy J.J. Rolim, Dionne B. Rodriguez, Jorge L.N. |
dc.subject.por.fl_str_mv |
Melioidosis Clinical guideline Diagnosis Antibiotics Burkholderia pseudomallei |
topic |
Melioidosis Clinical guideline Diagnosis Antibiotics Burkholderia pseudomallei |
description |
Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates. Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two stages; acute and eradication, will contribute to a reduction in mortality from melioidosis. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30959 |
url |
https://www.revistas.usp.br/rimtsp/article/view/30959 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30959/32843 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 48 No. 1 (2006); 1-4 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 48 Núm. 1 (2006); 1-4 Revista do Instituto de Medicina Tropical de São Paulo; v. 48 n. 1 (2006); 1-4 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
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