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Epidemiological and Clinical Features of Melioidosis: A Report of Seven Cases from Southern Inland China
Some subtropical regions with similar climatic conditions to melioidosis-endemic areas, such as southern Guangxi, may be new endemic zones for melioidosis. We retrospectively reviewed seven culture-proven melioidosis patients from October 2006 to March 2015. Their clinical characteristics, diagnosis, and treatment, and the geographical and environmental factors were analyzed. Seven male patients lived at latitudes of 21–23°N in Beihai, Nanning, Chongzuo City of the Guangxi Province. Symptom onset occurred during the rainy season. All patients had pneumonia, six patients had diabetes, five patients had a history of wounds or exposure to soil or water, and two patients had liver and spleen abscesses. Most patients were misdiagnosed before the confirmatory laboratory testing. The final diagnosis was confirmed as melioidosis by isolation of Burkholderia pseudomallei in a culture of blood or pus. The 6- to 17-month treatment included carbapenems, ceftazidime, or other antibiotics active against the organism in vitro. All patients initially appeared cured, but two subsequently had recurrent melioidosis. In non-highly endemic areas, there is often a lack of awareness of melioidosis, and this leads to misdiagnoses. Other subtropical regions with climatic conditions similar to the highly melioidosis-endemic areas such as southern Guangxi may also be melioidosis endemic.
Author Notes
Authors’ addresses: Yanping Tang, Jingmin Deng, Jianquan Zhang, Xiaoning Zhong, Hui Zhang, and Haiguang Xu, Department of Respiratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China, E-mails: yptang2015@sina.com, 1623995863@qq.com, jqzhang2002@sina.com, 593066814@qq.com, 905301095@qq.com, and 474283068@qq.com. Ye Qiu, Department of Comprehensive Internal Medicine, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China, E-mail: 287063367@qq.com.
These authors contributed equally to this work.