Central nervous system melioidosis in the pediatric age group: review

Research output: Contribution to journalReview article

2 Citations (Scopus)

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 follow-up 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.

Original languageEnglish
JournalChild's Nervous System
Volume33
Issue number6
DOIs
Publication statusPublished - 01-06-2017

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Melioidosis
Nervous System
Central Nervous System
Age Groups
Pediatrics
Meningoencephalitis
Abscess
Newborn Infant
Burkholderia pseudomallei
Cranial Nerve Diseases
Parietal Lobe
Brain Abscess
Ceftazidime
Mortality
PubMed
MEDLINE
Pharmaceutical Preparations
Communicable Diseases
Sepsis
Pneumonia

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

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title = "Central nervous system melioidosis in the pediatric age group: review",
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 follow-up 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.",
author = "Prasad, {G. Lakshmi} and Pushpa Kini and S. Divya",
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Central nervous system melioidosis in the pediatric age group : review. / Prasad, G. Lakshmi; Kini, Pushpa; Divya, S.

In: Child's Nervous System, Vol. 33, No. 6, 01.06.2017.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Central nervous system melioidosis in the pediatric age group

T2 - review

AU - Prasad, G. Lakshmi

AU - Kini, Pushpa

AU - Divya, S.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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 follow-up 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.

AB - 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 follow-up 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.

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