Whitmore disease has diverse and atypical clinical manifestations that are easily misdiagnosed with other diseases.
Male patient, D.V.N, 60 years old, in Chi Linh - Hai Duong has a history of severe diabetes. 2 weeks before being admitted to the hospital, the patient had a lot of cough; chills (40 degrees) with pain in the lumbar muscle area.
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| Whitmore disease has diverse and atypical clinical manifestations that are easily misdiagnosed with other diseases. |
The patient went to 2 medical facilities for examination and treatment but did not get better, the cause of the fever could not be found. The patient went to the Central Hospital for Tropical Diseases for treatment in a state of increasing muscle pain in the lumbar region and right shoulder joint, accompanied by high fever of unknown origin and severe fatigue.
After being transferred, the patient was treated actively, MRI of the shoulder joint showed inflammation and abscess of the subscapularis muscle, osteomyelitis, and purulent inflammation of the right shoulder joint.
Blood culture results showed Whitmore bacteria (scientific name Burkholderia pseudomallei), which is sensitive to some specific antibiotics to treat this bacteria.
This is fortunate because this bacteria is very resistant to drugs and difficult to treat. According to the patient's family, he did not travel anywhere outside of Hai Duong province. The distance he traveled was only from home to his workplace, a brick kiln near his house. He has had diabetes for 4 years but has had to inject insulin for the past year.
Dr. Nguyen Hong Long, Deputy Head of the Department of General Infections, shared that the Hai Duong area does not often report Whitmore cases. However, the disease can occur sporadically in the Northern Delta, and because it is a difficult disease to diagnose, it is also easy to miss.
Whitmore's disease has diverse clinical manifestations, and is atypical, easily misdiagnosed with other diseases. The disease can progress acutely, causing severe, critical, fatal sepsis, or it can cause chronic infection, hidden infection, lasting for months, even years.
When culturing specimens for diagnosis, bacteria often grow slowly and the growth rate is not high, making it even more difficult to diagnose the cause. Treatment is also difficult because bacteria are naturally resistant to many antibiotics, so it requires the right treatment regimen and enough time to control the disease.
In addition to the time the patient is hospitalized, when they return home, they must take medication for 3-4 months.
Up to now, after a period of active treatment, the patient's symptoms and accompanying complications have shown a clear improvement, the patient's fever has gone down, and the hospital's trauma surgery department has been consulted to consider surgery to clean the inflammation.
Whitmore disease is an infection in humans and animals caused by bacteria that naturally exist in soil and can contaminate water sources and is transmitted mainly through the skin when open wounds come into direct contact with contaminated soil, mud, or water.
Dr. Long emphasized that Whitmore disease is often found in people with underlying diseases such as diabetes, liver disease, kidney disease, chronic lung disease, immunodeficiency, etc. and has very diverse clinical manifestations, is difficult to diagnose and can lead to death due to complications of severe pneumonia, sepsis and septic shock. There is currently no vaccine to prevent Whitmore disease.
The main preventive measures are to ensure personal hygiene, environmental hygiene, use protective gear when working in contact with contaminated soil, mud, water or in unsanitary environments, clean and disinfect contaminated skin tears, scratches or burns, and practice cooking food and drinking boiled water...
To proactively prevent Whitmore disease, Dr. Long recommends that people take the following measures: Limit direct contact with soil and dirty water, especially in heavily polluted areas.
Do not bathe, swim, or dive in ponds, lakes, or rivers in or near polluted areas. Use protective gear (shoes, boots, gloves, etc.) for those who regularly work outdoors, in contact with soil, mud, and dirty water. Wash your hands frequently with soap and clean water, especially before and after preparing food, before eating, after using the toilet, and after working in the fields.
Eat cooked food and drink boiled water, ensure food hygiene and safety; do not slaughter or eat sick or dead animals, livestock or poultry.
When there is an open wound, ulcer or burn, avoid contact with potentially contaminated soil or water. If contact is unavoidable, use a waterproof bandage and wash thoroughly to ensure hygiene.
Especially for people with diabetes, chronic liver, kidney, lung disease, and immunodeficiency, care and protection of wounds are needed to prevent infection. When suspected of infection, go to a medical facility for consultation, examination, detection and timely treatment.
Source: https://baodautu.vn/vi-khuong-whitmore-xam-nhap-vao-co-the-theo-con-duong-nao-d218394.html
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