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Volume 27, Number 4—April 2021
Dispatch

Improving Treatment and Outcomes for Melioidosis in Children, Northern Cambodia, 2009–2018

Arjun Chandna1Comments to Author , Moritz Bonhoeffer1, Thyl Miliya, Keang Suy, Sena Sao, and Paul Turner
Author affiliations: Angkor Hospital for Children, Siem Reap, Cambodia (A. Chandna, M. Bonhoeffer, T. Miliya, K. Suy, S. Sao, P. Turner); University of Oxford, Oxford, UK (A. Chandna, P. Turner)

Main Article

Table 1

Characteristics for 355 children who had culture-confirmed melioidosis, northern Cambodia, 2009–2018*

Characteristic Value
Median age, y (IQR)
 5.7 (3.1–9.5)
Sex
M 255 (57.5)
F
 100 (42.5)
Concurrent condition, n = 355 14 (3.9)
Thalassemia 4
Systemic lupus erythematosus 2
Suspected underlying immunodeficiency 2
Asthma 1
Epilepsy 1
Acute lymphoblastic leukemia 1
Congenital heart disease 1
Chronic kidney disease 1
Pure red cell aplasia
 1
Clinical manifestations, n = 355
Parotitis 97 (27.3)
Skin or soft tissue infection 96 (27.0)
Pneumonia 69 (19.4)
Lymphadenitis 58 (16.3)
Meningitis 1 (0.3)
Multifocal infection 12 (3.4)
Other† 8 (2.3)
Unknown‡
 15 (4.5)
Management strategy, n = 355
Admitted case-patients 212 (59.7)
Case-patients admitted at first presentation 145 (40.8)
Empiric treatment with effective intensive-phase therapy 51
Treatment with effective intensive-phase therapy within 48 h 38
Treatment with effective intensive-phase therapy after 48 h 40
No effective intensive-phase therapy received§ 11
Treatment information not available
5
Admitted to intensive care unit, n = 212 52 (24.5)
Surviving patients completing 12 weeks of eradication therapy, n = 306 102 (33.3)
No. patients treated successfully with only oral antimicrobial drugs 39

*Values are no. (%) except as indicated. IQR, interquartile range.
†Clinical manifestations for patients classified as Other included mandibular osteomyelitis (2), diarrheal disease (2), vaginitis (2), mastoiditis (1), and septic arthritis (1). 
‡Clinical manifestations were unknown for 15 patients: 10 were bacteremic and 5 had Burkholderia pseudomallei isolated from pus swabs.
§A total of 9 children died within 24 h (before culture results were available), and 2 were switched directly to oral treatment.

Main Article

1These authors contributed equally to this article.

Page created: December 06, 2020
Page updated: March 18, 2021
Page reviewed: March 18, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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