Melioidosis in Sporadic Areas of Phang Nga Province, 2012-2026: Epidemiology and Management of Patients with Rare Complications
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Abstract
This retrospective descriptive study, combined with case reports, aimed to investigate the epidemiology, clinical features, laboratory findings, comorbidities, and diagnostic and management summaries of melioidosis patients with rare complications in sporadic areas. The study sample consisted of 42 patients diagnosed with confirmed melioidosis and admitted to Takua Pa Hospital, Phang Nga Province.
The results exhibited the majority of the sample were male, aged 50 years and older, and employed as general laborers. The average time from onset to hospitalization was 7.69 days. All patients were inpatients, and the disease was acute. The most common clinical symptoms were fever, abscess, pneumonia, and jaundice. Furthermore, 71.4% of the patients had comorbidities. The most common complication was hypertension (40.5%), followed by diabetes mellitus (31.0%) and chronic renal failure (16.7%). Laboratory findings showed abnormal neutrophil counts in 89.7%, eosinophil and lymphocyte counts in 86.2%, abnormal sodium and chloride counts in 82.8%, and abnormal albumin counts in 79.3%. Case studies of rare complications included: Case 1, disseminated melioidosis in a patient with hemoglobin H disease, resulting in liver and spleen abscesses and bleeding after drainage. This was controlled with transcatheter arterial embolization and FFP administration to prevent dilutional coagulopathy. Case 2 involved melioidosis with a scalp abscess, septic shock, and acute pericarditis, leading to pulseless VT and death.
These research findings help raise awareness and improve understanding among physicians and healthcare personnel in areas with sporadic melioidosis. Specifically, it is crucial to closely monitor patients with risk factors or comorbidities, diagnose cardiovascular complications or bleeding disorders rapidly, and manage medications and procedures comprehensively to reduce patient mortality.
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