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-
1.
Donnelly JP et al. 2020. Revision and update of the consensus definitions of invasive fungal disease from the European organization for research and treatment of cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis 71: 1367–1376.
-
2.
Chong GM , Maertens JA , Lagrou K , Driessen GJ , Cornelissen JJ , Rijnders BJA , 2016. Diagnostic performance of galactomannan antigen testing in cerebrospinal fluid. J Clin Microbiol 54: 428–431.
-
3.
Dixon C , 2011, Detection of Galactomannan in Broncho-Alveolar Lavage Fluids by Platelia Aspergillus Enzyme Immunoassay, Division of Special Pathogen and Transplant Products, Mycoses Study Group, Biorad Laboratories, USA and Sanofi Diagnostics, France.
-
4.
Lipsitz R et al. 2012. Workshop on treatment of and postexposure prophylaxis for Burkholderia pseudomallei and B. mallei infection, 2010. Emerg Infect Dis 18: e2.
-
5.
Pitman MC , Luck T , Marshall CS , Anstey NM , Ward L , Currie BJ , 2015. Intravenous therapy duration and outcomes in melioidosis: a new treatment paradigm. PLoS Negl Trop Dis 9: e0003586.
-
6.
Currie BJ et al. 2000. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 31: 981–986.
-
7.
Kingsley PV , Leader M , Nagodawithana NS , Tipre M , Sathiakumar N , 2016. Melioidosis in Malaysia: a review of case reports. PLoS Negl Trop Dis 10: e0005182.
-
8.
Currie BJ , Ward L , Cheng AC , 2010. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 4: e900.
-
9.
Wongwandee M , Linasmita P , 2019. Central nervous system melioidosis: a systematic review of individual participant data of case reports and case series. PLoS Negl Trop Dis 13: e0007320.
-
10.
Wiersinga WJ , Virk HS , Torres AG , Currie BJ , Peacock SJ , Dance DAB , Limmathurotsakul D , 2018. Melioidosis. Nat Rev Dis Primers 4: 17107.
-
11.
Mukhopadhyay C , Shaw T , Varghese GM , Dance DAB , 2018. Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan). Trop Med Infect Dis 3: 51.
-
12.
Sood S , Khedar RS , Joad SH , Gupta R , 2014. Septicaemic melioidosis: case report from a non-endemic area. J Clin Diagn Res 8: DD01–DD02.
-
13.
Garg G , Chawla N , Chawla K , Khosla P , Jain S , 2015. Atypical presentations of melioidosis in north India: report of two cases. J Assoc Physicians India 63: 82–83.
-
14.
Huang W , Wu G , Chen F , Li M , Li J , 2018. Multi-systemic melioidosis: a clinical, neurological, and radiological case study from Hainan province, China. BMC Infect Dis 18: 649.
-
15.
Vidyalakshmi K , Lipika S , Vishal S , Damodar S , Chakrapani M , 2012. Emerging clinico-epidemiological trends in melioidosis: analysis of 95 cases from western coastal India. Int J Infect Dis 16: e491–e497.
-
16.
Dance D , 2014. Treatment and prophylaxis of melioidosis. Int J Antimicrob Agents 43: 310–318.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 887 | 124 | 51 |
| Full Text Views | 390 | 194 | 0 |
| PDF Downloads | 251 | 86 | 0 |
Case Report: Isolated Central Nervous System Melioidosis from a Non-Endemic Area
Biswamohan Mishra
Biswamohan Mishra
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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Venugopalan Y. Vishnu
Venugopalan Y. Vishnu
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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Rohit Bhatia
Rohit Bhatia
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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Ajay Garg
Ajay Garg
Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India;
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Ramesh Sharanappa Doddamani
Ramesh Sharanappa Doddamani
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India;
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Parul Singh
Parul Singh
Department of Microbiology, All India Institue of Medical Sciences, New Delhi, India;
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Mehar Chand Sharma
Mehar Chand Sharma
Department of NeuroPathology, All India Institute of Medical Sciences, New Delhi, India
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Mamta Bhushan Singh
Mamta Bhushan Singh
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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Roopa Rajan
Roopa Rajan
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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Anu Gupta
Anu Gupta
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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Madakasira Vasantha Padma Srivastava
Madakasira Vasantha Padma Srivastava
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India;
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ABSTRACT
Central nervous system (CNS) melioidosis is a rare neurological infectious disease which carries a high mortality. We describe a previously healthy middle-aged female, who presented to us with left-sided hemiparesis and was on antitubercular therapy from a previous presumed diagnosis of CNS tuberculoma. Non-characteristic imaging picture, multiple negative body fluid cultures, and positive Cerebrospinal fluid galactomannan led to a further delay in diagnosis. Gram stain of the tissue obtained from brain biopsy revealed Gram-negative rods in “safety pin” appearance. By picking up the colonies that appeared on blood agar and MacConkey agar, the identification of the clinical isolates was performed using VITEK® matrix (BioMérieux, Marcy-L’Etoile, France)-assisted laser desorption ionization time-of-flight mass spectrometry (VITEK MALDI TOF MS database version 3.2) which revealed Burkholderia pseudomallei. After the institution of appropriate treatment, she survived but with significant morbidity. A high index of suspicion should be kept for such previously healthy individuals belonging to non-endemic areas, where presentation is suspicious of an infective etiology, but not improving despite appropriate therapy. This may help in early recognition and institution of recommended treatment so that mortality can be avoided.
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Author Notes
Authors’ addresses: Biswamohan Mishra, Venugopalan Y. Vishnu, Rohit Bhatia, Mamta Bhushan Singh, Roopa Rajan, Anu Gupta, and Madakasira Vasantha Padma Srivastava, Department of Neurology, All India Institute of Medical Sciences, New Delhi, India, E-mails: biswamohan26@gmail.com, vishnuvy16@yahoo.com, rohitbhatia71@yahoo.com, mbsneuro@gmail.com, rooparajan@aiims.edu, doctoranugupta1@gmail.com, and vasanthapadma123@gmail.com. Ajay Garg, Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India, E-mail: drajaygarg@gmail.com. Ramesh Sharanappa Doddamani and Parul Singh, Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India, E-mails: drsdramesh@gmail.com and parul5fiore@gmail.com. Mehar Chand Sharma, Department of NeuroPathology, All India Institute of Medical Sciences, New Delhi, India, E-mail: sharmamehar@yahoo.co.in.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Donnelly JP et al. 2020. Revision and update of the consensus definitions of invasive fungal disease from the European organization for research and treatment of cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis 71: 1367–1376.
-
2.
Chong GM , Maertens JA , Lagrou K , Driessen GJ , Cornelissen JJ , Rijnders BJA , 2016. Diagnostic performance of galactomannan antigen testing in cerebrospinal fluid. J Clin Microbiol 54: 428–431.
-
3.
Dixon C , 2011, Detection of Galactomannan in Broncho-Alveolar Lavage Fluids by Platelia Aspergillus Enzyme Immunoassay, Division of Special Pathogen and Transplant Products, Mycoses Study Group, Biorad Laboratories, USA and Sanofi Diagnostics, France.
-
4.
Lipsitz R et al. 2012. Workshop on treatment of and postexposure prophylaxis for Burkholderia pseudomallei and B. mallei infection, 2010. Emerg Infect Dis 18: e2.
-
5.
Pitman MC , Luck T , Marshall CS , Anstey NM , Ward L , Currie BJ , 2015. Intravenous therapy duration and outcomes in melioidosis: a new treatment paradigm. PLoS Negl Trop Dis 9: e0003586.
-
6.
Currie BJ et al. 2000. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 31: 981–986.
-
7.
Kingsley PV , Leader M , Nagodawithana NS , Tipre M , Sathiakumar N , 2016. Melioidosis in Malaysia: a review of case reports. PLoS Negl Trop Dis 10: e0005182.
-
8.
Currie BJ , Ward L , Cheng AC , 2010. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 4: e900.
-
9.
Wongwandee M , Linasmita P , 2019. Central nervous system melioidosis: a systematic review of individual participant data of case reports and case series. PLoS Negl Trop Dis 13: e0007320.
-
10.
Wiersinga WJ , Virk HS , Torres AG , Currie BJ , Peacock SJ , Dance DAB , Limmathurotsakul D , 2018. Melioidosis. Nat Rev Dis Primers 4: 17107.
-
11.
Mukhopadhyay C , Shaw T , Varghese GM , Dance DAB , 2018. Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan). Trop Med Infect Dis 3: 51.
-
12.
Sood S , Khedar RS , Joad SH , Gupta R , 2014. Septicaemic melioidosis: case report from a non-endemic area. J Clin Diagn Res 8: DD01–DD02.
-
13.
Garg G , Chawla N , Chawla K , Khosla P , Jain S , 2015. Atypical presentations of melioidosis in north India: report of two cases. J Assoc Physicians India 63: 82–83.
-
14.
Huang W , Wu G , Chen F , Li M , Li J , 2018. Multi-systemic melioidosis: a clinical, neurological, and radiological case study from Hainan province, China. BMC Infect Dis 18: 649.
-
15.
Vidyalakshmi K , Lipika S , Vishal S , Damodar S , Chakrapani M , 2012. Emerging clinico-epidemiological trends in melioidosis: analysis of 95 cases from western coastal India. Int J Infect Dis 16: e491–e497.
-
16.
Dance D , 2014. Treatment and prophylaxis of melioidosis. Int J Antimicrob Agents 43: 310–318.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 887 | 124 | 51 |
| Full Text Views | 390 | 194 | 0 |
| PDF Downloads | 251 | 86 | 0 |