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Melioidosis mycotic aneurysm: An uncommon complication of an uncommon disease.

Li PH, Chau CH, Wong PC - Respir Med Case Rep (2014)

Bottom Line: However it is an endemic disease in Southeast Asia and Northern Australia with an expanding distribution.The morbidity and mortality of this uncommon complication remains high despite prompt diagnosis and treatment.Especially when treating persistent/recurrent melioidosis, the physician's caution to the development of mycotic aneurysms is imperative so that early treatment and surgical intervention may be considered.

View Article: PubMed Central - PubMed

Affiliation: Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong.

ABSTRACT
Melioidosis is often considered an exotic and uncommon disease in most parts of the world. However it is an endemic disease in Southeast Asia and Northern Australia with an expanding distribution. Melioidosis can involve almost any organ and can deteriorate rapidly. In this report, we describe a rapidly fatal case of a mycotic aneurysm associated with melioidosis despite aggressive antibiotic therapy. The morbidity and mortality of this uncommon complication remains high despite prompt diagnosis and treatment. Especially when treating persistent/recurrent melioidosis, the physician's caution to the development of mycotic aneurysms is imperative so that early treatment and surgical intervention may be considered.

No MeSH data available.


Related in: MedlinePlus

Serial CXRs, taken 10 days apart (top) and contrast CT (bottom) showing rapid interval enlargement of the mycotic aneurysm.
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fig2: Serial CXRs, taken 10 days apart (top) and contrast CT (bottom) showing rapid interval enlargement of the mycotic aneurysm.

Mentions: In view of possible intravascular/bone involvement, the meropenam dose was escalated and doxycycline was added but still without clinical improvement. The patient was assessed by our cardiothoracic and vascular teams, but was deemed not suitable for surgery. Doxycycline was replaced by intravenous minocycline, and moxifloxacin was also added. However blood cultures were persistently positive for B. pseudomallei and the patient continued a downhill course. Serial CXR and CT (Fig. 2) showed rapid interval enlargement of aortic arch aneurysm. Despite continued antibiotic and supportive treatment, the patient complained of sudden onset of neck pain which was followed by massive haemoptysis. He succumbed on the same day, just within three weeks since his presentation of melioidosis relapse.


Melioidosis mycotic aneurysm: An uncommon complication of an uncommon disease.

Li PH, Chau CH, Wong PC - Respir Med Case Rep (2014)

Serial CXRs, taken 10 days apart (top) and contrast CT (bottom) showing rapid interval enlargement of the mycotic aneurysm.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356043&req=5

fig2: Serial CXRs, taken 10 days apart (top) and contrast CT (bottom) showing rapid interval enlargement of the mycotic aneurysm.
Mentions: In view of possible intravascular/bone involvement, the meropenam dose was escalated and doxycycline was added but still without clinical improvement. The patient was assessed by our cardiothoracic and vascular teams, but was deemed not suitable for surgery. Doxycycline was replaced by intravenous minocycline, and moxifloxacin was also added. However blood cultures were persistently positive for B. pseudomallei and the patient continued a downhill course. Serial CXR and CT (Fig. 2) showed rapid interval enlargement of aortic arch aneurysm. Despite continued antibiotic and supportive treatment, the patient complained of sudden onset of neck pain which was followed by massive haemoptysis. He succumbed on the same day, just within three weeks since his presentation of melioidosis relapse.

Bottom Line: However it is an endemic disease in Southeast Asia and Northern Australia with an expanding distribution.The morbidity and mortality of this uncommon complication remains high despite prompt diagnosis and treatment.Especially when treating persistent/recurrent melioidosis, the physician's caution to the development of mycotic aneurysms is imperative so that early treatment and surgical intervention may be considered.

View Article: PubMed Central - PubMed

Affiliation: Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong.

ABSTRACT
Melioidosis is often considered an exotic and uncommon disease in most parts of the world. However it is an endemic disease in Southeast Asia and Northern Australia with an expanding distribution. Melioidosis can involve almost any organ and can deteriorate rapidly. In this report, we describe a rapidly fatal case of a mycotic aneurysm associated with melioidosis despite aggressive antibiotic therapy. The morbidity and mortality of this uncommon complication remains high despite prompt diagnosis and treatment. Especially when treating persistent/recurrent melioidosis, the physician's caution to the development of mycotic aneurysms is imperative so that early treatment and surgical intervention may be considered.

No MeSH data available.


Related in: MedlinePlus