Meliodosis of Head and Neck Regions

Abstract

          A retrospective descriptive study was performed in patients with meliodosis of head and neck, confirmed by cultures of pus to be infected with Burkholderia pseudomallei. Patients were admitted to the ENT department at Sunpasitthiprasong Hospital, during January 2551-December 2556. There were 39 patients (28 men and 11 women), most of them aged less than 10 years (51.28%). Mainly, they were present at the hospital during rainy seasons from May to August (69.23%). Two patients had history of a car accident and one had history of tooth extraction, before they had got symptoms. Most patients had no history of underlying disease (66.67%). For those who  had ones, diabetes mellitus was majority. The most common sites of disease found were parotid gland (parotid abscess) and neck (cervical abscess). The symptoms found in more than half of patients were swelling of face
and neck, high fever and trismus. All patients were treated by surgical drainage. Culture results showed that the bacteria were resistant to ampicillin, gentamicin, as the response to chloramphenicol, cotrimazole, ciprofloxacin, tetracycline, ceftazidime, amoxil-clavulanate, sulperazone and imipenem. Most patients received medicines as ceftazidime(66.66%), followed by clindamycin in combination with ceftazidime(20.51%). Twelve patients underwent ultrasound of abdomen, which found that two patients had infection that spread to other organs i.e. splenic abscess and liver abscess. In this study, none was dead.