Clinical Features and CT Imaging Findings of Melioidosis Pneumonia

MAI Sheng-shi; ZHU Hong-zhang; ZHAO Guang-qiang; CHEN Hai; ZHANG Meng

doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0619

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Clinical Features and CT Imaging Findings of Melioidosis Pneumonia

Clinical Research | 更新时间：2024-02-19

- Clinical Features and CT Imaging Findings of Melioidosis Pneumonia
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 44, Issue 6, Pages: 1038-1045(2023)
- 作者机构：
  
  1.三亚市人民医院放射科,海南三亚 572000
  2.中山大学附属第一医院放射诊断专科,广东广州 510080
  3.三亚市人民医院呼吸内科,海南三亚 572000
  4.三亚市人民医院检验科,海南三亚 572000
- 作者简介：
  
  ZHU Hong-zhang； E-mail： zhhzhang@mail.sysu.edu.cn
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0619
  CLC： R445.3
- Published：20 November 2023，
  
  Received：03 August 2023，
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麦盛始,朱洪章,赵光强等.类鼻疽肺炎的临床特征与CT影像学表现[J].中山大学学报（医学科学版）,2023,44(06):1038-1045.

MAI Sheng-shi,ZHU Hong-zhang,ZHAO Guang-qiang,et al.Clinical Features and CT Imaging Findings of Melioidosis Pneumonia[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(06):1038-1045.
麦盛始,朱洪章,赵光强等.类鼻疽肺炎的临床特征与CT影像学表现[J].中山大学学报（医学科学版）,2023,44(06):1038-1045. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0619.

MAI Sheng-shi,ZHU Hong-zhang,ZHAO Guang-qiang,et al.Clinical Features and CT Imaging Findings of Melioidosis Pneumonia[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(06):1038-1045. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0619.

摘要

目的

归纳与分析类鼻疽肺炎的临床特征与CT影像学表现，以提高对其的认识。

方法

回顾性分析2012年1月1日至2023年4月1日间68例类鼻疽肺炎的临床与CT影像资料。

结果

在68例确诊患者中，62例患者为急性感染，6例患者为慢性感染。88.2%患者为男性，85.3%患者是海南原籍居民，85.3%患者职业为农民，77.9%患者发病于夏、秋两季，66.2%患者有糖尿病，100%患者的首发临床症状为发热。88.2%患者经血液培养试验阳性确诊。多数患者的白细胞计数、中性粒细胞比例、C-反应蛋白以及降钙素水平升高，而淋巴细胞比率则普遍下降，但是在急性感染和慢性感染组间的差异无统计学意义（

0.05）。36.8%患者治愈，42.6%患者较治疗前好转，11.8%患者迁延不愈，8.8%患者死亡。肺内病变在CT图像上的形态主要表现为结节或肿块、斑片状磨玻璃影和大片状实变影，三种形态可同时并存。急性感染和慢性感染组的影像学表现差异在于主要的病变形态（

= 0.01），其余的影像征象的差异并无统计学意义。此外，36.8%患者出现肺外感染，其中8.8%患者为多部位脓肿形成。

结论

对于有疫区旅居史、糖尿病、高热、病情进展迅速的患者，并且CT提示肺内存在多发炎症性病灶，医务人员应提高对此病的警惕。

Abstract

Objective

To summarize and analyze the clinical features and CT imaging findings of melioidosis pneumonia in order to increase awareness of this disease.

Methods

A retrospective study was done on clinical and CT imaging data of 68 cases with melioidosis pneumonia diagnosed from January 1， 2012 to April 1， 2023.

Results

Of the 68 cases， 62 presented with acute infection and 6 chronic infection， 88.2% were male， 85.3% were native residents of Hainan， 85.3% were farmers， 77.9% had onset in summer and autumn， 66.2% had diabetes， 100% had fever as the first clinical symptom， and 88.2% were confirmed positive by blood culture. In most patients， white blood cell count， neutrophil ratio， C-reactive protein and calcitonin levels increased， while lymphocyte ratio decreased， but no statistical difference was found between acute and chronic infection groups （

0.05）. Of the patients， 36.8% recovered， 42.6% got better， 11.8% patients became therapy-resistant and 8.8% died. CT image showed pathomorphological changes including nodules/masses， patchy ground-glass attenuation or large patchy consolidation or all of these at the same time. Acute and chronic infection groups had significant difference in pathomorphological changes （

= 0.01）， but no statistical difference in other imaging findings. Moreover， 36.8% of the patients developed extrapulmonary infections， 8.8% of which multi-site abscess formation.

Conclusions

Melioidosis Pneumonia should be considered if the patient is the sojourner from epidemic area， or has diabetes， high fever and rapid-developing disease， with additional presence of multiple inflammatory lesions in lung CT.

关键词

类鼻疽肺炎伯霍尔德杆菌发热体层摄影术X线计算机

Keywords

melioidosispneumoniaburkholderia pseudomalleifevertomographyX-ray computer

references

中国微生物学会医学微生物学与免疫学专业委员会，重庆市微生物学会临床微生物专业委员会. 类鼻疽诊断与治疗专家共识［J］. 中华传染病杂志， 2022， 40（10）： 577-583.

Medical Microbiology And Immunology Committee of Chinese Society for Microbiology， Clinical Microbiology Committee of Chongqing Society for Microbiology. Expert consensus on diagnosis and treatment of melioidosis［J］. Chin J Infect Dis， 2022， 40（10）： 577-583.

Limmathurotsakul D， Golding N， Dance DA， et al. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis［J］. Nat Microbiol， 2016， 1：15008.

Currie BJ， Ward L， Cheng AC. The epidemiology and clinical spectrum of melioidosis： 540 cases from the 20 year Darwin prospective study［J］. PLoS Negl Trop Dis， 2010， 4（11）： e900.

Wiersinga WJ， Virk HS， Torres AG， et al. Melioidosis［J］. Nat Rev Dis Primers， 2018， 4：17107.

Karunanayake P. Melioidosis： clinical aspects［J］. Clin Med （Lond）， 2022， 22（1）： 6-8.

Lim KS， Chong VH. Radiological manifestations of melioidosis［J］. Clin Radiol， 2010， 65（1）： 66-72.

Norman FF， Chen LH. Travel-associated melioidosis： a narrative review［J］. J Travel Med， 2023， 30（3）： taad039.

Birnie E， Virk HS， Savelkoel J， et al. Global burden of melioidosis in 2015： a systematic review and data synthesis［J］. Lancet Infect Dis， 2019， 19（8）： 892-902.

Zheng W， Kuang S， Zhong C， et al. Risk factors for melioidosis mortality and epidemics： a multicentre， 10-year retrospective cohort study in Northern Hainan［J］. Infect Dis Ther， 2023， 12（3）： 951-964.

Currie BJ， Mayo M， Ward LM， et al. The darwin prospective melioidosis Study： a 30-year prospective， observational investigation［J］. Lancet Infect Dis， 2021， 21（12）： 1737-1746.

Willcocks SJ， Denman CC， Atkins HS， et al. Intracellular replication of the well-armed pathogen Burkholderia pseudomallei［J］. Curr Opin Microbiol， 2016， 29： 94-103.

Sia TLL， Mohan A， Ooi MH， et al. Epidemiological and clinical characteristics of melioidosis caused by gentamicin-susceptible burkholderia pseudomallei in sarawak， malaysia［J］. Open Forum Infect Dis， 2021， 8（10）： ofab460.

邝仕成，钟成望，郑婉婷，等. 2000-2020年海口市类鼻疽病的流行病学和临床特征分析［J］. 中华地方病学杂志， 2022， 41（2）： 149-154.

Kuang SC， Zhong CW， Zheng WT， et al. Epidemiological and clinical characteristics of melioidosis in Haikou City in 2000-2020［J］. Chin J Endemiol， 2022， 41（2）： 149-154.

Sullivan RP， Marshall CS， Anstey NM， et al. 2020 Review and revision of the 2015 Darwin melioidosis treatment guideline； paradigm drift not shift［J］. PLoS Negl Trop Dis， 2020， 14（9）： e0008659.

Grund ME， Soo JC， Cote CK， et al. Thinking outside the bug： targeting outer membrane proteins for burkholderia vaccines［J］. Cells， 2021， 10（3）： 495.

俞安乐，陈海，李群. 12例类鼻疽的影像表现分析［J］. 中华放射学杂志， 2007， 41（11）： 1186-1188.

Yu AL， Chen H， Li Q. Imaging and clinical analysis of 12 cases with melioidosis［J］. Chin J Radiol， 2007， 41（11）： 1186-1188.

Ko SF， Kung CT， Lee YW， et al. Imaging spectrum of thoracic melioidosis［J］. J Thorac Imaging， 2013， 28（3）： W43-48.

Muttarak M， Peh WC， Euathrongchit J， et al. Spectrum of imaging findings in melioidosis［J］. Br J Radiol， 2009， 82（978）： 514-521.

Burivong W， Wu X， Saenkote W， et al. Thoracic radiologic manifestations of melioidosis［J］. Curr Probl Diagn Radiol， 2012， 41（6）： 199-209.

钟有清，林慧. 类鼻疽肺炎26例临床特点与影像学表现［J］. 中国现代医学杂志， 2014， 24（19）： 88-91.

Zhong YQ， Lin H. 26 cases of melioidosis pneumonia： clinical and radiological features［J］. China J Mod Med， 2014， 24（19）： 88-91.

Khiangte HL， Robinson Vimala L， et al. Can the imaging manifestations of melioidosis prognosticate the clinical outcome？ a 6-year retrospective study［J］. Insights Imaging， 2019， 10（1）： 17.

Alsaif HS， Venkatesh SK. Melioidosis： spectrum of radiological manifestations［J］. Saudi J Med Med Sci， 2016， 4（2）： 74-78.

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Related Institution

Department of Radiology，Baoan Central Hospital of Shenzhen

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School of Pharmaceutical Sciences (Shenzhen), Shenzhen Campus of Sun Yat-sen University

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