Central nervous system melioidosis in the pediatric age group: review

Prasad, Lakshmi G and Kini, Pushpa and Divya, S (2017) Central nervous system melioidosis in the pediatric age group: review. Child's Nervous System, 33 (6). pp. 1-6. ISSN 0256-7040

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Abstract

Purpose Melioidosis is a potentially fatal infectious disease caused by Burkholderia pseudomallei. Neurologic involvement in pediatric age group is very rare, and only a handful of cases have been reported in literature. We sought to provide a systematic review of pediatric neurologic melioidosis. Methods: Literature review was performed to analyze reported cases of pediatric neurologic melioidosis (≤16 years) by searching online database (PubMed/MEDLINE). Results :Twenty-seven cases were analyzed. Mean age was 6.7 years (range 2 days–14 years) and around 50% were older children (>5 years). Cranial nerve palsies and fever were most common presenting features. Major manifestations were meningoencephalitis in 16 (59%) and cerebral abscesses in eight (29%) cases. Abscesses were mostly located in parietal lobe. Among older children, abscesses were common than meningeal disease, while being converse for neonates. Mean followup duration was 11.5 months. Ten cases showed good to excellent outcome, while eight cases had fair (incomplete recovery) outcomes. The overall mortality rate was 18.5% (5/27) and tends to decrease with age. Among the five deaths, 4 (80%) had septicemia or pneumonia. Conclusions: Pediatric neurologic melioidosis is very rare. Meningoencephalitis is the most common presentation. Mortality is the highest in neonates. Ceftazidime appears to be the drug of choice in intensive phase, although the best drug in maintenance phase cannot be commented upon, especially in very young children.

Item Type: Article
Uncontrolled Keywords: Melioidosis ; Pediatric ; Central nervous system ;Meningoencephalitis ; Cerebral abscess ; Burkholderia ;pseudomallei.
Subjects: Dentistry > MCODS Manipal > Orthodontics
Medicine > KMC Manipal > Neuro Surgery
Medicine > KMC Manipal > Paediatrics
Depositing User: KMC Library
Date Deposited: 19 Jun 2017 04:00
Last Modified: 19 Jun 2017 04:00
URI: http://eprints.manipal.edu/id/eprint/149055

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