Clinical and radiological characteristics of mediastinal melioidosis: A four-year retrospective cohort from Sabah, Malaysia

Larry Ellee Nyanti and Muhammad Zahid Abdul Muien and Amalina Abu Othman and Chia, Yen Lik and Mahabalraj Singh Peshi and Valerie Toh and Nur Siti Fatimah Mohamad Jamil and Meryl Grace Lansing and Huan, Nai Chien and Hema Yamini Ramarmuty and Kunji Kannan Sivaraman Kannan (2024) Clinical and radiological characteristics of mediastinal melioidosis: A four-year retrospective cohort from Sabah, Malaysia. Respiratory Medicine Case Reports, 234. pp. 1-4. ISSN 0954-6111

Text FULL TEXT.pdf Restricted to Registered users only Download (992kB) | Request a copy

Abstract

Background Melioidosis is a potentially fatal tropical infection. Little is known about mediastinal involvement in melioidosis. This study aimed to (a) describe the prevalence and demographics of various morphologies of mediastinal melioidosis, (b) propose a classification for radiological morphologies of mediastinal melioidosis. Methods A retrospective cohort study was performed. Case records of consecutive patients with culture-positive melioidosis who underwent computed tomography (CT) thorax from January 1, 2018–February 28, 2022, were reviewed. Results 486 culture-positive melioidosis patients were identified, of which 70 underwent CT thorax. 41 patients demonstrating mediastinal involvement were included in the final analysis, of which four were mediastinal collections, while the rest were classified into those with necrotic or matted appearances, and subcentimeter and larger than 1 cm. Culture-positivity was proven from blood in 83 % of patients (n = 34), with the remaining from chest wall pus, neck abscess pus, sputum, liver abscess, seminal vesicle, pleural, pericardial and peritoneal fluid. The most commonly associated pulmonary manifestations were consolidation and pleural effusion. Half had diabetes; a quarter had chronic kidney disease, while one had syphilis. Exposure to soil was present in six patients: quarry (n = 1), construction (n = 2), farmer (n = 1), living environment (n = 2). Seven patients succumbed before the end of 6-week intensive phase antibiotic treatment. Conclusion Mediastinal melioidosis is a spectrum with multiple overlapping features consisting of necrosis, matted lymph nodes, multiseptated and non-septated collections. Further studies will elucidate the prognostic implications of mediastinal melioidosis.

Item Type:	Article
Keyword:	Mediastinal melioidosis, Mediastinal lymphadenopathy, Melioidosis, Mediastinal mass, Mediastinal collection
Subjects:	R Medicine > RC Internal medicine > RC31-1245 Internal medicine > RC109-216 Infectious and parasitic diseases R Medicine > RD Surgery > RD1-811 Surgery
Department:	FACULTY > Faculty of Medicine and Health Sciences
Depositing User:	SITI AZIZAH BINTI IDRIS -
Date Deposited:	12 Aug 2025 12:31
Last Modified:	12 Aug 2025 12:31
URI:	https://eprints.ums.edu.my/id/eprint/44929

Actions (login required)

View Item