Analysis of Clinical Features and Literature Summary of Melioidosis Death Cases

LAN Tianzhou; ZHAO Guangqiang; FANG Juan; LIU Haichao; WANG Bin; MAO Congzheng; HU Zhenhong; FANG Yao; MAO Xuhu

doi:10.13730/j.issn.2097-2148.2025.05.007

Abstract：Objective To analyze the epidemiological and clinical characteristics of fatal melioidosis cases to enhance clinicians' awareness of the dangers of melioidosis.Methods Clinical data from 138 patients diagnosed with melioidosis at Sanya People's Hospital,Hainan Province,from June 2012 to December 2023 were reviewed,and the epidemiological and clinical characteristics of the 21 death cases were analyzed.Results Among the 21 death cases,the proportion of males was high(17/21,80.95％),and most of the cases were from Sanya city(17/21,80.95％),with an average age of(50.16±19.16);half of the patients had history of environmental exposure(18/21,85.71％),of which 13 patients(61.90％)had history of long-term contact with infested water or soil,and 5 patients(23.81％)had history of trauma,the most common underlying disease was diabetes mellitus(13/21,61.90％).Fever(80.95％)and cough(38.10％)were the main onset symptoms of the deceased patients with melioidosis,and the disease progressed rapidly,more than half of the patients were complicated with septic shock and multiple organ dysfunction syndrome(MODS)(15/21,71.43％for both)during hospitalization,and the average survival time was 11.00(4.50,16.00).The most common clinical infection type was bacteremia(20/21,95.24％),with disseminated infections accounting for 85.71％(18/21).In the blood biochemical examination,the high sen-sitivity C-reactive protein(hs-CRP)was(328.88±110.21)mg/L,the procalcitonin(PCT)concentration was 59.23(15.44,120.00)ng/ml,both of which were markedly elevated.The main imaging findings on chest CT were nodular shadows(10/19,52.63％).Conclusion Patients who succumb to melioidosis are predominantly middle-aged males,particularly those with history of out-door employment and trauma.The initial symptoms of melioidosis lack specificity are primarily characterized by upper re-spiratory tract infections such as fever and cough,early chest CT findings are mostly dominated by nodular shadows,but the marked elevation of hs-CRP and PCT levels in blood biochemical examination merits close attention.For patients with bacteremia in areas with high incidence of infection,it is necessary to focus on ruling out the possibility of disseminated melioidosis infection and preventing rapid progression of the disease.