Volume 28, Number 8—August 2022
Dispatch
Child Melioidosis Deaths Caused by Burkholderia pseudomallei–Contaminated Borehole Water, Vietnam, 2019
Table 1
Demographic and clinical characteristics and corresponding isolates from 3 children who died of melioidosis caused by Burkholderia pseudomallei–contaminated borehole water, Vietnam, 2019*
Characteristics | Case 1 |
Case 2 |
Case 3 |
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---|---|---|---|---|---|---|---|---|---|---|
Age, y/sex |
7/F |
5/M |
1/M |
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Date | ||||||||||
Symptom onset | Apr 6 | Oct 27 | Nov 10 | |||||||
Hospital admission | Apr 9 | Oct 28 | Nov 11 | |||||||
Death |
Apr 9 |
Oct 31 |
Nov 16 |
|||||||
Signs and symptoms | High fever, abdominal pain, vomiting, diarrhea with mucous, tachycardia, and cyanosis | High fever, abdominal pain, vomiting, tachypnea, and tachycardia | High fever, poor appetite, mild pitting edema in the feet and hands, tachypnea, and tachycardia | |||||||
Underlying disease |
Not detectable |
Not detectable |
Not detectable |
|||||||
Microbiology | ||||||||||
Blood culture | ND | B. pseudomallei–positive | B. pseudomallei–positive | |||||||
Sequence type | ND | 541 | 541 | |||||||
Other sample cultures |
ND |
ND |
ND |
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Antimicrobial drug treatment |
Cefoperazone in the first day; then efoperazone and amikacin on subsequent days |
Ceftriaxone, tobramycin, and metronidazole in the first day; then meropenem and levofloxacin on subsequent days |
Ceftazidime in the first 2 days; meropenem in the last 3 days |
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Imaging at admission | ||||||||||
Chest radiograph | NA | No abnormalities noted | No abnormalities noted | |||||||
Abdominal radiograph | NA | No abnormalities noted | NA | |||||||
Abdominal ultrasound |
NA |
No abnormalities noted |
NA |
|||||||
Laboratory findings | Day 1 |
Day 2 |
Day 1 |
Day 2 |
Day 1 |
Day 3 |
Day 4 |
Day 5 |
||
WBC, × 109 cells/L | 0.6 | 0.7 | 25.2 | 0.35 | 10.8 | 7.5 | 1.35 | 1.06 | ||
Neutrophils, × 109 cells/L | NA | 0.12 | 22.8 | 0.05 | 8.4 | 4.0 | 0.76 | 0.38 | ||
Lymphocytes, × 109 cells/L | NA | 0.48 | 1.07 | 0.29 | 1.52 | 3.07 | 0.50 | 0.55 | ||
Platelets, × 109 cells/L | 47 | 36 | 272 | 29 | 264 | 172 | 67 | 32 | ||
Urea, mmol/L | 8.9 | 9.9 | NA | 9.8 | 2.2 | 1.4 | 3.7 | 4.1 | ||
Creatinine, µmol/L | 91 | 123 | NA | 124 | 45 | 33 | 55 | 71 | ||
AST, U/L | 571 | 713 | NA | 602 | 23 | 59 | 185 | 269 | ||
ALT, U/L | 226 | 258 | NA | 166 | 10 | 40 | 94 | 73 | ||
CRP, mg/L | 124 | NA | 26 | 148 | 57 | NA | 209 | 158 | ||
PCT, ng/mL | NA | >100 | NA | >100 | 9 | 43 | NA | NA |
*Data were collected from the St. Paul Hospital and Vietnam National Children’s Hospital, except for the laboratory findings for case 1, which were retrieved from the child’s local hospital. ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; NA, not available; ND, not done; PCT, procalcitonin; WBC, white blood cell count.