title: An 11-Year Analysis of Emergency Presentations of Melioidosis in Northeastern Malaysia.
abstract: A neglected tropical disease, melioidosis is known to have variability in clinical presentations. Here, we described clinical features that should alert the physicians on the possibility of melioidosis. In this review of 86 cases from 2001 to 2011, the common presentations of melioidosis in the Emergency Department (ED), Hospital Universiti Sains Malaysia were; male gender (79.1 %), in working age group (47.8 ± 15.2 year-old), worked in contact with soil (73.3 %), presented with fever (91.9 %), in rainy season (55.8 %), have underlying diabetes mellitus (79.1 %), have leukocytosis (67.4 %) and high blood glucose (62.8 %) during presentation. In 34.9 % of cases, the antimicrobials were initiated at the ED and only 10.5 % include antimelioid drugs. Thirty-one patients (36.0 %) died due to melioidosis and 51.6 % of this were within 48 h of admission. Despite high mortality rate, the clinical awareness on the possibility of melioidosis among emergency physicians is still low and need to be strengthened.
authors.affiliation: Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Mohd Boniami
authors.initials: MB
authors.lastname: Yazid
authors.affiliation: Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Mohd Hashairi
authors.initials: MH
authors.lastname: Fauzi
authors.affiliation: Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Habsah
authors.initials: H
authors.lastname: Hasan
authors.affiliation: Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Abu Yazid
authors.initials: AY
authors.lastname: Md Noh
authors.affiliation: Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia. zakuan@usm.my.
authors.forename: Zakuan Zainy
authors.initials: ZZ
authors.lastname: Deris
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D000067565:Farmers / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D007964:Leukocytosis / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008554:Melioidosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Emergency presentations; Malaysia; Melioidosis; Neglected tropical diseases