• 1

    Whitmore A, Krishnaswami CS, 1912. An account of the discovery of a hitherto undescribed infective disease occurring among the population of Rangoon. Indian Med Gaz 47 :262–267.

    • Search Google Scholar
    • Export Citation
  • 2

    Su HP, Yang HW, Chen YL, Ferng TL, Chou YL, Chung TC, Chen CH, Chiang CS, Kuan MM, Lin HH, Chen YS, 2007. Prevalence of melioidosis in the Er-Ren River Basin, Taiwan: implications for transmission. J Clin Microbiol 45 :2599–2603.

    • Search Google Scholar
    • Export Citation
  • 3

    Cheng AC, Currie BJ, 2005. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 18 :383–416.

  • 4

    Lim KB, Oh HM, 2007. Melioidosis complicated by pericarditis. Scand J Infect Dis 39 :357–359.

  • 5

    Majid AA, 1990. Successful surgical management of a case of pulmonary and pericardial melioidosis. Aust N Z J Surg 60 :139–141.

  • 6

    Uka K, Aikata H, Takaki S, Shirakawa H, Jeong SC, Yamashina K, Hiramatsu A, Kodama H, Takahashi S, Chayama K, 2007. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma. World J Gastroenterol 13 :414–420.

    • Search Google Scholar
    • Export Citation
  • 7

    Seki S, Kitada T, Sakaguchi H, Nakatani K, Kamino T, Nakamura K, Yamada R, 2001. Cardiac tamponade caused by spontaneous rupture of mediastinal lymph node metastasis of hepatocellular carcinoma. J Gastroenterol Hepatol 16 :702–704.

    • Search Google Scholar
    • Export Citation
  • 8

    Pankuweit S, Ristic AD, Seferovic PM, Maisch B, 2005. Bacterial pericarditis: diagnosis and management. Am J Cardiovasc Drugs 5 :103–112.

    • Search Google Scholar
    • Export Citation
  • 9

    Chung WS, Chang RE, Guo HR, 2007. Variations of care quality for infectious pulmonary tuberculosis in Taiwan: a population based cohort study. BMC Public Health 7 :107.

    • Search Google Scholar
    • Export Citation
  • 10

    Chen RF, Lai CP, 2005. Clinical characteristics and treatment of constrictive pericarditis in Taiwan. Circ J 69 :458–460.

  • 11

    Spodick DH, 1956. Tuberculous pericarditis. Arch Intern Med 98 :737–749.

  • 12

    Ip M, Osterberg LG, Chau PY, Raffin TA, 1995. Pulmonary melioidosis. Chest 108 :1420–1424.

  • 13

    Currie BJ, 2003. Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions. Eur Respir J 22 :542–550.

    • Search Google Scholar
    • Export Citation
  • 14

    Cherian G, 2004. Diagnosis of tuberculous aetiology in pericardial effusions. Postgrad Med J 80 :262–266.

  • 15

    Ngauy V, Lemeshev Y, Sadkowski L, Crawford G, 2005. Cutaneous melioidosis in a man who was taken as a prisoner of war by the Japanese during World War II. J Clin Microbiol 43 :970–972.

    • Search Google Scholar
    • Export Citation
  • 16

    Chierakul W, Anunnatsiri S, Short JM, Maharjan B, Mootsikapun P, Simpson AJ, Limmathurotsakul D, Cheng AC, Stepniewska K, Newton PN, Chaowagul W, White NJ, Peacock SJ, Day NP, Chetchotisakd P, 2005. Two randomized controlled trials of ceftazidime alone versus ceftazidime in combination with trimethoprim-sulfamethoxazole for the treatment of severe melioidosis. Clin Infect Dis 41 :1105–1113.

    • Search Google Scholar
    • Export Citation
  • 17

    Chaowagul W, Chierakul W, Simpson AJ, Short JM, Stepniewska K, Maharjan B, Rajchanuvong A, Busarawong D, Limmathurotsakul D, Cheng AC, Wuthiekanun V, Newton PN, White NJ, Day NP, Peacock SJ, 2005. Open-label randomized trial of oral trimethoprim-sulfamethoxazole, doxycycline, and chloramphenicol compared with trimethoprim-sulfamethoxazole and doxycycline for maintenance therapy of melioidosis. Antimicrob Agents Chemother 49 :4020–4025.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

Non-septicemic Melioidosis Presenting as Cardiac Tamponade

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  • 1 Division of Infectious Diseases and Division of Gastroenterology, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China

Melioidosis is endemic in Taiwan. It is caused by infection with Burkholderia pseudomallei. A prolonged course of oral eradication therapy to avoid relapse after an intensive intravenous therapy is recommended to treat melioidosis. Melioidosis with cardiac involvement is rare and is often combined with septicemia, for which the mortality rate is 20–60%. The initial clinical presentations of melioidosis mimic Mycobacterium tuberculosis infection, which is the most common etiology of bacterial pericarditis in Taiwan. We present a case of non-septicemic melioidosis that presented as non-suppurative cardiac tamponade and left subcarinal lymphadenopathy. Underlying diseases included hepatitis B–related liver cirrhosis and hepatocellular carcinoma. The patient was successfully treated with 2 weeks of intravenous ceftazidime and 12 weeks of oral doxycycline, trimethoprim-sulfamethoxazole, and amoxicillin/clavulanate. Melioidosis-related pericarditis should be considered in the differential diagnoses of bacterial pericarditis in Taiwan.

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