Introduction: Melioidosis is a tropical infectious disease caused by Gramnegative bacteria Burkholderia pseudomallei (B. pseudomallei). This soil-borne disease is endemic in Southeast Asia and Northern Australia. In o...Introduction: Melioidosis is a tropical infectious disease caused by Gramnegative bacteria Burkholderia pseudomallei (B. pseudomallei). This soil-borne disease is endemic in Southeast Asia and Northern Australia. In our country it was reported once before in 2000 in a patient who presented with subdural empyema. Case Series Report: We are reporting six cases of Melioidosis presented to our hospital in very close time with different clinical presentations. All patients were from Indian subcontinent. In 3 cases we treated with Meropenem plus Trimethoprim-Sulfamethoxazole (TMP-SMX) followed by oral TMP-SMX and Doxycycline for around 6 months with good clinical and radiological response, while the fourth case was treated with oral TMP-SMX and Doxycycline for 1 month but he lost to follow up, the Fifth cases were treated with IV Ceftazidime followed by TMP-SMX and Doxycycline for 9 weeks, the Sixth cases were treated with IV Ceftazidime followed by TMP-SMX and Amoxicillin/Clavulanic acid for 20 days, there was no mortality reported in our case series for both types Bactraemic and Abactraemic Melioidosis. Conclusions: This case series highlights the importance of early identification of B. pseudomallei which requires a high index of clinical suspicion as well as good understanding of demographical and travel history. Microbiological identification of B. pseudomallei is essential and requires notification of the microbiologist for suspicion of that infection. Prolonged antimicrobial therapy is required for a better clinical outcome.展开更多
Background: There is limited information about extra pulmonary tuberculosis (EPTB) in Qatar. The aim of this study is to describe the demographic characteristics of patients with Tuberculosis (TB) in Qatar, and to com...Background: There is limited information about extra pulmonary tuberculosis (EPTB) in Qatar. The aim of this study is to describe the demographic characteristics of patients with Tuberculosis (TB) in Qatar, and to compare the characteristics of EPTB with those of Pulmonary Tuberculosis (PTB). Patients and Methods: The study was conducted at Hamad Medical Corporation (HMC) in Qatar, from January 2005 to December 2008. It involves all cases of TB diagnosed in Qatar which do not include patients who are diagnosed by routine screening tests upon entry to state of Qatar. Results: 1221 cases of TB were reported;654 (53.6%) were EPTB;and 567 (46.4%) were PTB. Nine hundred fifty-one (77.9%) were males and two hundred and seventy (22.1%) were females;the mean age was 32.7 ± 811.7 years;only 6.9% (84/1221) of them were Qataris. The most frequent associated condition was diabetesmellitus (DM) (30;2.5%), and the most frequent site involved was lymph node (285 cases;43.5%). One thousand two hundred patients continued on first-line drugs while 21 patients received second line treatment. The mean duration of antituberculous therapy was 6.7 ± 1.7 months. Hepatitis was the main drug toxicity. Eight hundred and forty seven patients (69.3%) cured and eight patients (0.7%) died, whereas the remaining three hundred and sixty-six patients (30.0%) had left the country before completing therapy. The proportion of EPTB among females was higher than males, whereas diabetes mellitus was strongly associated with PTB. Conclusion: TB is still common in Qatar with predominance of EPTB. Although male predominated, the proportion of TB, EPTB among females was higher than males.展开更多
文摘Introduction: Melioidosis is a tropical infectious disease caused by Gramnegative bacteria Burkholderia pseudomallei (B. pseudomallei). This soil-borne disease is endemic in Southeast Asia and Northern Australia. In our country it was reported once before in 2000 in a patient who presented with subdural empyema. Case Series Report: We are reporting six cases of Melioidosis presented to our hospital in very close time with different clinical presentations. All patients were from Indian subcontinent. In 3 cases we treated with Meropenem plus Trimethoprim-Sulfamethoxazole (TMP-SMX) followed by oral TMP-SMX and Doxycycline for around 6 months with good clinical and radiological response, while the fourth case was treated with oral TMP-SMX and Doxycycline for 1 month but he lost to follow up, the Fifth cases were treated with IV Ceftazidime followed by TMP-SMX and Doxycycline for 9 weeks, the Sixth cases were treated with IV Ceftazidime followed by TMP-SMX and Amoxicillin/Clavulanic acid for 20 days, there was no mortality reported in our case series for both types Bactraemic and Abactraemic Melioidosis. Conclusions: This case series highlights the importance of early identification of B. pseudomallei which requires a high index of clinical suspicion as well as good understanding of demographical and travel history. Microbiological identification of B. pseudomallei is essential and requires notification of the microbiologist for suspicion of that infection. Prolonged antimicrobial therapy is required for a better clinical outcome.
文摘Background: There is limited information about extra pulmonary tuberculosis (EPTB) in Qatar. The aim of this study is to describe the demographic characteristics of patients with Tuberculosis (TB) in Qatar, and to compare the characteristics of EPTB with those of Pulmonary Tuberculosis (PTB). Patients and Methods: The study was conducted at Hamad Medical Corporation (HMC) in Qatar, from January 2005 to December 2008. It involves all cases of TB diagnosed in Qatar which do not include patients who are diagnosed by routine screening tests upon entry to state of Qatar. Results: 1221 cases of TB were reported;654 (53.6%) were EPTB;and 567 (46.4%) were PTB. Nine hundred fifty-one (77.9%) were males and two hundred and seventy (22.1%) were females;the mean age was 32.7 ± 811.7 years;only 6.9% (84/1221) of them were Qataris. The most frequent associated condition was diabetesmellitus (DM) (30;2.5%), and the most frequent site involved was lymph node (285 cases;43.5%). One thousand two hundred patients continued on first-line drugs while 21 patients received second line treatment. The mean duration of antituberculous therapy was 6.7 ± 1.7 months. Hepatitis was the main drug toxicity. Eight hundred and forty seven patients (69.3%) cured and eight patients (0.7%) died, whereas the remaining three hundred and sixty-six patients (30.0%) had left the country before completing therapy. The proportion of EPTB among females was higher than males, whereas diabetes mellitus was strongly associated with PTB. Conclusion: TB is still common in Qatar with predominance of EPTB. Although male predominated, the proportion of TB, EPTB among females was higher than males.
