Septicemic Melioidosis: Factor for Fatal Outcome in Burirum Hospital.
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Abstract
Background: Septicemicmelioidosis is a common community acquired septicemia in northeastern Thailand. The overall mortallity still high despite of effective antibiotic treatment
Objective: To study the clinical manifestations, laboratory investigations, treatments, result and prognostic factors of septicemic melioidosis patients.
Research design: This research is retrospective analytical study
Subject: All patients with positive hemoculture for Burholderiapseudomallei in Burirum Hospital during 1st Jan 2003 - 31th Dec 2004.
Statistics: Descriptive statistic: frequency, percent, mean, median, standard deviation. Analytical statistic:Chi-square, Fisher’s exact test and logistic regression to identify prognostic factors.
Results:142 cases of septicemic melioidosis was documented during 2 years period.overallmortallity was 63.4%. Death from septicemia was associated with failure to develop a leukocytosis (odd ratio 3.46;95% Cl: 1.02-11.68, p=0.045) and no history fever (odd ratio 10.0:95% Cl: 1.18-100, p=0.035) Septicemic melioidosis presented mainly in the rainy season, occured predominantly in rice farmers. Pneumonia was the most common site of infection and the mortality was high(75.5%). Indirect hemagglutination assay was positive only 22.2% of cases.
Conclusion: The clinical manifestations of septicemic melioidosis are nonspecific. The factors that associated with fatal outcome are failure to develop leukocytosis and no history of fever. Septicemic melioidosis is a major cause of morbidity and mortality in northeast Thailand
Key word: septicemic, melioidosis
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References
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