Consecutive patients infected with Whitmore bacteria hospitalized

Whitmore's disease has a diverse clinical course and symptoms, requiring differential diagnosis from many diseases. When diagnosed and treated incorrectly, the disease has a high mortality rate, up to 40%.

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Recently, the Tropical Disease Center, Bach Mai Hospital has continuously received cases with symptoms of fever, loss of appetite, weight loss, swelling and abscesses in some areas of the body. The signs and symptoms of the patients are very similar and often confused with tuberculosis and staphylococcal infections.

Here, doctors diagnosed a suspected case of Whitmore's disease, conducted blood and pus cultures from the abscesses, and provided a treatment regimen for the patient. After detecting the bacteria Burkholderia pseudomallei, the bacteria that causes Whitmore's disease (Melioidosis), the patient was explained and advised on a long-term treatment regimen to avoid recurrence.

For example, patient TVL, 58 years old (Soc Son, Hanoi) was admitted to the hospital with pneumonia, prostate and rectal abscesses, poor appetite, and weight loss. Abscesses are infections caused by bacteria.

The patient shared that there had been a case of Whitmore disease death in the area where he lived. Similarly, patient PCG, 48 years old (Can Loc, Ha Tinh) worked as a farmer, construction worker, and was often exposed to mud and dirt.

The patient was admitted to the hospital with fever, swelling, pain, abscess on the left hand, and bone pain. Previously, the patient had many abscesses in different locations on the body, recurring, and treatment at lower levels could not find the cause.

As for patient V.D.L., 45 years old, (Truc Ninh, Nam Dinh), he had a normal health history. Mr. V.D.L. had a high fever for many days, swelling and pain in his right buttock, coughed up phlegm, had difficulty breathing, and was hospitalized in a state of severe septic shock.

All three patients had underlying diabetes, one of whom was found to have underlying diabetes after being hospitalized for treatment of fever, pneumonia, and abscesses. In one patient, Whitmore had even penetrated into the bone, causing inflammation.

Whitmore cases are treated with antibiotics; abscesses are treated, blood sugar is controlled, nutrition is maintained, and physical condition is improved. Currently, the patients have no fever, abscesses are treated, health has improved, and they can eat and walk.

Recently, Bach Mai Hospital received another special case. That is a male patient LDD, 45 years old (Thai Binh), with a history of diabetes and working as a ship driver at sea, the patient was found to have an abscess in the brain.

After more than 20 days of treatment, the patient's fever and headache subsided, and his test results were stable. However, this case requires antibiotic treatment and continued monitoring for at least the next 6 months.

Recently, many hospitals have also received and treated Whitmore cases. For example, Hoa Binh General Hospital has treated 2 cases of Whitmore disease. Previously, at the end of August, Dong Nai province also recorded a case of Whitmore bacteria infection, a 14-year-old girl.

Similarly, the Central Hospital for Tropical Diseases also treated a male patient, D.VN (69 years old, in Chi Linh City, Hai Duong Province), with Whitmore's disease and a history of severe diabetes.

Dr. Nguyen Hong Long, Deputy Head of the Department of General Infections, Central Hospital for Tropical Diseases, said that Whitmore has diverse clinical manifestations and is difficult to diagnose, so the disease is easily missed or misdiagnosed with other diseases. Therefore, patients can die from pneumonia, sepsis and septic shock.

Whitmore's disease usually develops acutely with symptoms such as pneumonia, infection of bones and joints, nervous system, liver, spleen, prostate, sepsis, or septic shock. The disease can develop chronically with symptoms of pneumonia like tuberculosis or abscesses of many organs like staphylococcal infection.

Whitmore is transmitted through the respiratory tract or contact with an environment containing bacteria. Especially when there are scratches on the skin, the risk of infection is higher and the disease progresses faster.

People with one or more underlying diseases such as diabetes, alcoholism, chronic lung, kidney, and liver disease, especially diabetes, are at high risk of infection, which can easily cause dangerous complications, which can lead to death. If treated properly and with adequate regimen, patients can be cured, however, the mortality rate is high, up to 40%.

To minimize the risk of Whitmore, Associate Professor, Dr. Do Duy Cuong, Director of the Center for Tropical Diseases, Bach Mai Hospital, recommends that people should not come into direct contact with soil, dirty water, or stagnant water for a long time, especially when there are skin wounds, scratches, bleeding; or people with many underlying diseases.

“Vietnam is an endemic area for Whitmore. When patients have fever, inflammation, and abscesses in many places, they should immediately think about the risk of Whitmore, especially those with underlying diabetes. Early detection of Whitmore is very important in the treatment process and regimen, minimizing the risk of death,” Associate Professor, Dr. Do Duy Cuong noted.

According to the Department of Preventive Medicine, Ministry of Health, currently whitmore is a disease that has no vaccine, nor is there any recommendation on the use of preventive antibiotics.

Therefore, although the above preventive measures are very basic, we should not be subjective. In people with poor resistance (for example, people with chronic infections, long-term use of corticosteroids, diabetes, kidney disease or alcoholics, drug addicts, etc.): when bacteria enter the blood, it will cause more severe sepsis. Therefore, these people are at higher risk and need to pay more attention to disease prevention.

The main preventive measures are to ensure personal hygiene, environmental hygiene, use protective gear when working in contact with contaminated soil or water or in unsanitary environments, thoroughly clean skin lacerations, scratches or contaminated burns, and practice cooking food and drinking boiled water.

Source: https://baodautu.vn/lien-tiep-benh-nhan-mac-vi-khuan-whitmore-nhap-vien-d225144.html