Article

Short report: disease severity and outcome of melioidosis in HIV coinfected individuals.

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
The American journal of tropical medicine and hygiene (Impact Factor: 2.53). 01/2006; 73(6):1165-6.
Source: PubMed

ABSTRACT This study examined whether coinfection with HIV and Burkholderia pseudomallei leads to altered disease severity or outcome associated with melioidosis. Coinfection was detected in only 8 of 524 (1.5%) adults with melioidosis in northeast Thailand. Clinical presentation and acute outcome were similar in HIV-positive and HIV-negative patients.

0 Bookmarks
 · 
70 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The clinical manifestations of HIV infection vary widely in distinct geographical areas. While HIV-related disease has been well characterized in western countries, relatively few publications have described the clinical manifestations of these diseases in tropical areas, where the vast majority of HIV-infected people are concentrated. In addition, HIV infection may alter the natural history of tropical diseases in several ways and tropical diseases influence the course of HIV infection. The present review describes the major opportunistic infections afflicting people with HIV/AIDS in Africa, Latin America, and Asia and discusses the mutual interactions between HIV and the major tropical diseases.
    Enfermedades Infecciosas y Microbiología Clínica 05/2008; 26 Suppl 5:6-11. · 1.48 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Melioidosis (Burkholderia pseudomallei infection) is a common cause of community-acquired sepsis in Northeast Thailand and northern Australia. B. pseudomallei is a soil saprophyte endemic to Southeast Asia and northern Australia. The clinical presentation of melioidosis may mimic tuberculosis (both cause chronic suppurative lesions unresponsive to conventional antibiotics and both commonly affect the lungs). The two diseases have overlapping risk profiles (e.g., diabetes, corticosteroid use), and both B. pseudomallei and Mycobacterium tuberculosis are intracellular pathogens. There are however important differences: the majority of melioidosis cases are acute, not chronic, and present with severe sepsis and a mortality rate that approaches 50% despite appropriate antimicrobial therapy. By contrast, tuberculosis is characteristically a chronic illness with mortality <2% with appropriate antimicrobial chemotherapy. We examined the gene expression profiles of total peripheral leukocytes in two cohorts of patients, one with acute melioidosis (30 patients and 30 controls) and another with tuberculosis (20 patients and 24 controls). Interferon-mediated responses dominate the host response to both infections, and both type 1 and type 2 interferon responses are important. An 86-gene signature previously thought to be specific for tuberculosis is also found in melioidosis. We conclude that the host responses to melioidosis and to tuberculosis are similar: both are dominated by interferon-signalling pathways and this similarity means gene expression signatures from whole blood do not distinguish between these two diseases.
    PLoS ONE 01/2013; 8(1):e54961. · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Melioidosis, caused by the saprophytic soil and fresh-water Gram-negative aerobic bacillus Burkholderia pseudomallei, is classically characterised by pneumonia, sometimes with multiple organ abscesses, usually in patients with defined risk factors and with a mortality rate of up to 40%. It is a major cause of community-acquired sepsis in Southeast Asia and tropical northern Australia with an expanding global geographical distribution. It is increasingly recognised as an opportunistic infectious disease of importance to physicians, who may need to suspect it in at-risk patients that may come from or visit endemic areas, and could be fatal if treated late or inappropriately. Mortality could be prevented by early institution of specific antimicrobial therapy. Epidemiology, clinical features, overall management, and aspects of melioidosis particularly relevant to kidney disease and immunosuppression are discussed in this review.
    Nephrology 12/2012; · 1.69 Impact Factor

Full-text (2 Sources)

Download
44 Downloads
Available from
May 22, 2014