Cutaneous melioidosis: a review of the literature

被引:12
作者
Fertitta, Laura [1 ]
Monsel, Gentiane [1 ]
Torresi, Joseph [2 ]
Caumes, Eric [1 ]
机构
[1] Hop La Pitie Salpetriere, Sorbonne Univ, Infect Dis Dept, 47 Blvd Hop, F-75651 Paris 13, France
[2] Peter Doherty Inst Infect & Immun, Dept Microbiol & Immunol, Melbourne, Vic, Australia
关键词
PSEUDOMALLEI;
D O I
10.1111/ijd.14167
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background Melioidosis is mainly observed in South-East Asia, where Burkholderia pseudomallei is endemic. Cutaneous melioidosis (CM) has rarely been described and in contrast to systemic forms, there are no therapeutic recommendations to guide management. Methods We reviewed the literature published before January 2018, evaluating: dermatological presentation, natural history, diagnostic methods, and treatment options. We also distinguish between primary and secondary CM in which the infection first started in the skin or came from an extracutaneous localization, respectively, and chronic CM when duration exceeded 2 months. The recommended treatment for systemic forms included ceftazidime or meropenem, followed by oral maintenance therapy with cotrimoxazole or amoxicillin - clavulanic acid. Results Forty-three cases were published in 38 articles. Twenty-nine patients (67.4%) were travelers, including 13 (44.8%) returning from Thailand. Thirty-eight patients (88%) had primary CM, including nine (29.9%) with chronic infection. All cases of secondary CM first presented with acute infection. The median incubation time was 3 weeks. The most common presentation was cutaneous abscesses (58%). The recommended treatment was administered in 62.7% cases with 37.2% for maintenance therapy. Sixteen patients (37.2%) underwent surgery. Death was reported in less than 5%. Conclusion CM should be considered in travelers returning from or residents of endemic countries, particularly Thailand, presenting with cutaneous abscesses, cellulitis, or ulcerations. Surgery may be necessary in a substantial proportion of patients and follow-up of at least 1 year is essential. Therapeutic recommendations need to be established.
引用
收藏
页码:221 / 227
页数:7
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