Point-of-Care Ultrasound in the Diagnosis of Melioidosis in Laos.
Huson, Michaëla AM;
Kling, Kerstin;
Chankongsin, Somaphone;
Phongluxa, Khampheng;
Keoluangkhot, Valy;
Newton, Paul N;
Dance, David;
Heller, Tom;
Neumayr, Andreas;
(2020)
Point-of-Care Ultrasound in the Diagnosis of Melioidosis in Laos.
The American Journal of Tropical Medicine and Hygiene, 103 (2).
pp. 675-678.
ISSN 0002-9637
DOI: https://doi.org/10.4269/ajtmh.20-0069
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Melioidosis is endemic in many rural areas in Southeast Asia where facilities for culture and identification of Burkholderia pseudomallei are often limited. We performed a prospective observational study in patients presenting with fever to Mahosot Hospital, the primary referral hospital in Laos, to establish whether the detection of abscesses on ultrasound could support a presumptive diagnosis of melioidosis. All patients underwent ultrasound examination to detect abscesses in the liver, spleen, prostate, or, if indicated, subcutaneous tissue. We enrolled 153 patients, including 18 patients with melioidosis. Of these, 11 (61%) had an abscess at one or more sites, including five (28%) with splenic and/or liver abscesses. Absence of abscesses cannot rule out melioidosis, but the positive predictive value of abscesses for melioidosis was high at 93% (88-96%). Therefore, in endemic areas, the presence of abscesses in febrile patients should prompt empiric antibiotic therapy for melioidosis even in the absence of culture confirmation.