Cerebral melioidosis in Singapore: a review of five cases.
A variety of neurological manifestations of infection with Burkholderia pseudomallei have been described including cerebral abscesses, which are a well-recognized form of neurological melioidosis. The optimal antibiotic therapy for this condition has not been defined; however, combinations of intravenous antibiotics are frequently used in the early stages. Five cases of melioidosis involving brain abscesses are described which presented in Singapore over the past 3 years (1997-2000), 4 of which cases had evidence of disseminated infection. Despite profound neurological deficits and low Glasgow Coma Scale scores at presentation in 3 of these cases, all survived after surgical drainage and prolonged courses of intravenous ceftazidime or imipenem, and only 2 of whom had residual neurological impairment. One incidental finding on computed tomography (CT) or magnetic resonance imaging (MRI) scans not described before as an association with cerebral melioidosis was sinusitis in 4 out of the 5 cases.
Chadwick
D R
DR
Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore. david.chadwick@addenbrookes.nhs.uk
Ang
B
B
Sitoh
Y Y
YY
Lee
C C
CC
D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D016957:Burkholderia pseudomallei; D002442:Ceftazidime / Q000627:therapeutic use; D004322:Drainage / Q000379:methods; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008554:Melioidosis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged
D015378:Imipenem; D002442:Ceftazidime