• 1.

    Gassiep I , Armstrong M , Norton R , 2020. Human melioidosis. Clin Microbiol Rev 33: e00006-19.

  • 2.

    Currie BJ et al., 2021. The Darwin Prospective Melioidosis Study: a 30-year prospective, observational investigation. Lancet Infect Dis 11: e0005650.

    • Search Google Scholar
    • Export Citation
  • 3.

    Mohan A et al., 2017. Pediatric melioidosis in Sarawak, Malaysia: epidemiological, clinical and microbiological characteristics. PLoS Negl Trop Dis 21: 17371746.

    • Search Google Scholar
    • Export Citation
  • 4.

    Alvarez-Hernandez G , Cruz-Loustaunau D , Ibarra JA , Rascon-Alcantar A , Contreras-Soto J , Meza-Radilla G , Torres AG , Estrada-de Los Santos P , 2021. Description of two fatal cases of melioidosis in Mexican children with acute pneumonia: case report. BMC Infect Dis 21: 204.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Katanami Y et al., 2017. A fatal case of melioidosis with pancytopenia in a traveler from Indonesia. J Infect Chemother 23: 241244.

  • 6.

    Carcillo JA , Shakoory B , Castillo L , 2019. Secondary hemophagocytic lymphohistiocytosis, macrophage activation syndrome, and hyperferritinemic sepsis-induced multiple-organ dysfunction syndrome in the pediatric ICU. Mastropietro CW , Valentine KM , eds. Pediatric Critical Care: Current Controversies. Cham, Switzerland: Springer International Publishing, 245255.

    • Search Google Scholar
    • Export Citation
  • 7.

    Shakoory B , Carcillo JA , Chatham WW , Amdur RL , Zhao H , Dinarello CA , Cron RQ , Opal SM , 2016. Interleukin-1 receptor blockade is associated with reduced mortality in sepsis patients with features of macrophage activation syndrome: reanalysis of a prior phase III trial. Crit Care Med 44: 275281.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Sia TLL et al., 2021. Epidemiological and clinical characteristics of melioidosis caused by gentamicin-susceptible Burkholderia pseudomallei in Sarawak, Malaysia. Open Forum Infect Dis 8: ofab460.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Mohan A et al., 2021. Fine-needle aspiration to improve diagnosis of melioidosis of the head and neck in children: a study from Sarawak, Malaysia. BMC Infect Dis 21: 1069.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    WHO , 2021. Child growth standards. In: Tools and Toolkits. Available at: http://www.who.int/childgrowth/en/. Accessed January 16, 2022.

  • 11.

    CDC , 2017. Clinical growth charts. In: Growth Charts. Available at: https://www.cdc.gov/growthcharts/clinical_charts.htm. Accessed January 16, 2022.

  • 12.

    Khemani RG , Smith LS , Zimmerman JJ , Erickson S , 2015. Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 16: S23S40.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Opal SM et al., 1997. Confirmatory interleukin-1 receptor antagonist trial in severe sepsis: a phase III, randomized, double-blind, placebo-controlled, multicenter trial. The Interleukin-1 Receptor Antagonist Sepsis Investigator Group. Crit Care Med 25: 11151124.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Akcan-Arikan A , Zappitelli M , Loftis LL , Washburn KK , Jefferson LS , Goldstein SL , 2007. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 71: 10281035.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Chandna A , Bonhoeffer M , Miliya T , Suy K , Sao S , Turner P , 2021. Improving treatment and outcomes for melioidosis in children, northern Cambodia, 2009–2018. Emerg Infect Dis 27: 11691172.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Carcillo JA , Halstead ES , Hall MW , Nguyen TC , Reeder R , Aneja R , Shakoory B , Simon D , 2017. Three hypothetical inflammation pathobiology phenotypes and pediatric sepsis-induced multiple organ failure outcome. Pediatr Crit Care Med 18: 513523.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Beig J , Read K , Welch D , Bhally H , 2017. Melioidosis with possible Haemophagocytic lymphohistiocytosis. N Z Med J 130: 7679.

  • 18.

    Smith S , Munas AM , Hanson J , 2018. Hemophagocytic lymphohistiocytosis complicating melioidosis. Am J Trop Med Hyg 99: 557558.

Past two years Past Year Past 30 Days
Abstract Views 4045 4045 595
Full Text Views 46 46 9
PDF Downloads 49 49 13
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Fatal Pediatric Melioidosis and the Role of Hyperferritinemic Sepsis-Induced Multiple-Organ Dysfunction Syndrome

Anand MohanDepartment of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia;
Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia;

Search for other papers by Anand Mohan in
Current site
Google Scholar
PubMed
Close
,
Malini ParanchothyDepartment of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia;

Search for other papers by Malini Paranchothy in
Current site
Google Scholar
PubMed
Close
,
Sakthy SegaranDepartment of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia;

Search for other papers by Sakthy Segaran in
Current site
Google Scholar
PubMed
Close
,
Richard Siu-Chiu WongDepartment of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia;

Search for other papers by Richard Siu-Chiu Wong in
Current site
Google Scholar
PubMed
Close
,
Yek-Kee ChorDepartment of Pediatrics, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia

Search for other papers by Yek-Kee Chor in
Current site
Google Scholar
PubMed
Close
,
Yuwana PodinInstitute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia;

Search for other papers by Yuwana Podin in
Current site
Google Scholar
PubMed
Close
, and
Mong-How OoiInstitute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia;
Department of Pediatrics, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia

Search for other papers by Mong-How Ooi in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Melioidosis is reported to cause a high fatality rate in children, even in the absence of risk factors for disease. The aim of this study was to identify characteristics of fatal pediatric melioidosis infection. We performed a retrospective analysis of children aged < 15 years with culture-confirmed melioidosis admitted to Bintulu Hospital in Sarawak, Malaysian Borneo, from January 2011 to December 2020. Forty-one children had culture-confirmed melioidosis. Nine (22%) had a fatal outcome; 8 (89%) had no predisposing risk factors. Bacteremia, septic shock, and acute respiratory distress syndrome were present in all fatalities. Demographic characteristics, presenting manifestation, and disseminated infection were not significantly associated with mortality, whereas the presence of splenomegaly, cytopenia, disseminated intravascular coagulation, and hepatobiliary dysfunction, all of which are features of hyperferritinemic sepsis-induced multiple-organ dysfunction syndrome, were associated with mortality. Hyperferritinemic sepsis-induced multiple-organ dysfunction syndrome may be a key component in the pathogenesis of fatal pediatric melioidosis.

Author Notes

Address correspondence to Anand Mohan, Hospital Bintulu, Jalan Nyabau, Bintulu 97000, Sarawak, Malaysia. E-mail: anand_bintulu@yahoo.com

Authors’ addresses: Anand Mohan, Malini Paranchothy, Sakthy Segaran, and Richard Siu-Chiu Wong, Department of Pediatrics, Bintulu Hospital, Bintulu, Sarawak, Malaysia, E-mails: anand_bintulu@yahoo.com, malni91@hotmail.com, sakthy.segaran@gmail.com, and richard_wong82@hotmail.com. Yek-Kee Chor and Mong-How Ooi, Department of Pediatrics, Sarawak General Hospital, Kuching, Sarawak, Malaysia, E-mails: drchoryekee@hotmail.com and monghowooi@gmail.com. Yuwana Podin, Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia, E-mail: pyuwana@unimas.my.

Save