Rationale:Melioidosis is a serious opportunistic infection caused by Burkholderia(B.)pseudomallei,primarily affecting immunocompromised individuals,particularly in endemic regions.Timely diagnosis and appropriate trea...Rationale:Melioidosis is a serious opportunistic infection caused by Burkholderia(B.)pseudomallei,primarily affecting immunocompromised individuals,particularly in endemic regions.Timely diagnosis and appropriate treatment are crucial to prevent fatal outcomes.Patient concerns:Case 1 was a 34-year-old male kidney transplant recipient who presented with a 15-day history of intermittent fever,accompanied by liver and spleen abscesses.Case 2 was a 37-year-old female kidney transplant recipient who presented with acute febrile illness and developed leucopenia.Blood cultures for both patients grew B.pseudomallei.Diagnosis:Both patients were diagnosed with melioidosis caused by B.pseudomallei,with the diagnosis confirmed through pus culture from the liver abscess in Case 1 and blood culture in Case 2.Interventions:Both patients were treated with an intensive regimen of meropenem(renal-adjusted doses),followed by a 3-month course of oral cotrimoxazole for eradication therapy.Outcomes:Case 1 experienced resolution of liver and spleen abscesses after 3 months of treatment and continued to recover well.In Case 2,blood cultures became sterile after 4 weeks,with no further complications observed.Lessons:Melioidosis should be suspected in immunocompromised patients,especially kidney transplant recipients,who present with unexplained fever and sepsis-like symptoms.Early diagnosis through aspiration of abscesses and prompt treatment are critical for preventing relapses and improving patient outcomes.展开更多
文摘Rationale:Melioidosis is a serious opportunistic infection caused by Burkholderia(B.)pseudomallei,primarily affecting immunocompromised individuals,particularly in endemic regions.Timely diagnosis and appropriate treatment are crucial to prevent fatal outcomes.Patient concerns:Case 1 was a 34-year-old male kidney transplant recipient who presented with a 15-day history of intermittent fever,accompanied by liver and spleen abscesses.Case 2 was a 37-year-old female kidney transplant recipient who presented with acute febrile illness and developed leucopenia.Blood cultures for both patients grew B.pseudomallei.Diagnosis:Both patients were diagnosed with melioidosis caused by B.pseudomallei,with the diagnosis confirmed through pus culture from the liver abscess in Case 1 and blood culture in Case 2.Interventions:Both patients were treated with an intensive regimen of meropenem(renal-adjusted doses),followed by a 3-month course of oral cotrimoxazole for eradication therapy.Outcomes:Case 1 experienced resolution of liver and spleen abscesses after 3 months of treatment and continued to recover well.In Case 2,blood cultures became sterile after 4 weeks,with no further complications observed.Lessons:Melioidosis should be suspected in immunocompromised patients,especially kidney transplant recipients,who present with unexplained fever and sepsis-like symptoms.Early diagnosis through aspiration of abscesses and prompt treatment are critical for preventing relapses and improving patient outcomes.
