Table 1.
Clinical presentation, epidemiology, bacteriology, and outcomes of invasive melioidosis in Sri Lanka. The main clinical presentation categories, their corresponding clinical features, Burkholderia pseudomallei genotypes and survival outcomes of culture-positive invasive melioidosis in Sri Lanka
| Clinical presentation | Age | Gender | Occupation | District, province | Exposure | Travel | Comorbidities | Diagnosed | Specimen | YLF/BTFC | MLST | Outcome* |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Systemic infection with multiple foci (9) | ||||||||||||
| Septic arthritis/encephalitis/sepsis | 58 | M | Unknown | Puttalum, North Western | Rural, unknown | Unknown | Diabetes/renal transplant | February 2008 | Blood | YLF | 1134 | Died |
| Multiple skin abscesses/multifocal septic arthritis/sepsis | 58 | F | Housewife | Kandy, Central | Rural construction | Unknown | None | March 2006 | Blood/joint fluid | YLF | 1132 | Recovered |
| Pneumonia/splenic abscess/sepsis | 62 | M | Retired school principal | Kurunegala, North Western | Rural, rice farming, gardening | None | Diabetes | February 2013 | Blood | YLF | 1136 | Recovered/relapsed |
| Psoas abscess/abdominal muscle abscess/pneumonia/sepsis | 44 | M | Policeman | Galle, Southern | Rural, active service | None | Diabetes | September 2013 | Blood | YLF | 1136 | Recovered |
| Psoas abscess/chest wall abscess/sepsis | 29 | M | Builder | Gampaha, Western | Rural, construction | None | Diabetes | December 2011 | Pus/blood | YLF | 1137 | Recovered |
| Skin and soft tissue abscess/sepsis | 59 | M | Garage mechanic | Kurunegala, North Western | Urban, construction | None | Diabetes | July/August 2012 | Blood | BTFC | 1139 | Recovered |
| Splenic abscess/septicarthritis/sepsis | 54 | M | Trishaw driver | Kalutara, Western | Rural, rice farming/gardening | Kuwait | Diabetes/liver disease | March 2013 | Blood/joint fluid | YLF | 1140 | Recovered/relapsed |
| Liver abscess/septic arthritis/sepsis | 31 | M | Builder | Hambantota, Southern | Rural, construction, river bathing | None | Diabetes/alcoholism | December 2013 | Blood/joint fluid | BTFC | 1143 | Recovered/relapsed |
| Chronic liver disease/splenic abscess/sepsis | 48 | M | Physician | Kandy, Central | Suburban, flood exposure | None | None | March 2014 | Blood | YLF | 1147 | Recovered |
| Systemic infection with single-organ focus (7) | ||||||||||||
| Pneumonia/sepsis | 26 | F | Housewife | Badulla, Uva | Rural, unknown | Unknown | Diabetes | November 2007 | Blood | YLF | 1133 | Died |
| Pneumonia/sepsis | 80 | M | Farmer | Matara, Southern | Rural, rice farming | None | Alcoholism | October 2012 | Blood | YLF | 1137 | Died |
| Pneumonia/sepsis | 79 | M | School principal | Hambantota, Southern | Rural, gardening | Unknown | None | December 2012 | Blood | YLF | 1137 | Died |
| Psoas abscess/sepsis | 37 | F | Housewife | Anuradhapura, North Central | Rural, unknown | Unknown | Diabetes | May 2010 | Psoas abscess/blood | YLF | 1137 | Died |
| Pneumonia/sepsis | 62 | M | Farmer | Kandy, Central | Rural, rice farming | None | COPD* | December 2012 | Blood | YLF | 1135 | Recovered |
| Pneumonia/lung abscess/sepsis | 53 | F | Housewife | Gampaha, Western | Urban, unknown | Unknown | Diabetes | June 2010 | Blood | YLF | 1137 | Recovered |
| Liver abscess/sepsis | 40 | M | Policeman | Galle, Southern | Rural, active service, rice farming | None | Diabetes | July 2013 | Blood | YLF | 1140 | Recovered |
| Systemic infection with no localized focus (2) | ||||||||||||
| Sepsis | 45 | M | Unknown | Colombo, Western | Suburban | Unknown | Alcoholism | November 2008 | Postmortem blood | YLF | 1135 | Died |
| Sepsis | 63 | M | Civil defense | Ampara, Eastern | Rural, active service, cultivation | None | Lepromatous Leprosy | January 2014 | Blood | YLF | 1144 | Recovered |
| Multifocal tissue infections without systemic infection (5) | ||||||||||||
| Liver abscess/splenic abscess | 32 | M | Farmer | Badulla, Uva | Rural, rice farming | Unknown | Diabetes | September 2011 | Liver abscess | BTFC | 1138 | Died |
| Pneumonia/pericardial effusion | 40 | F | Unknown | Gampaha, Western | Unknown | Unknown | Diabetes | September 2013 | Pericardial fluid | YLF | 1142 | Died |
| Pneumonia/liver abscess/pleural effusion | 15 | F | Schoolgirl | Moneragala, Uva | Rural, unknown | None | Thalassaemia | December 2012 | Pleural aspirate | YLF | 1148 | Recovered |
| Pneumonia/septic arthritis | 50 | M | Farmer | Mullaitivu, Northern | Rural, rice farming | None | Diabetes/alcoholism | January 2013 | Joint fluid | YLF | 202 | Recovered |
| Muscular abscess/osteomyelitis/septic arthritis/liver abscess | 61 | M | Farmer | Puttalum, North Western | Rural, rice farming, river bathing | None | Diabetes | January 2014 | Muscular abscess | YLF | 1145 | Recovered/relapsed |
| Single-organ focus without systemic infection (9) | ||||||||||||
| Liver abscess | 27 | M | Soldier | Ampara, Eastern | Rural, active service | Unknown | Diabetes | July/August 2011 | Postmortem liver abscess | YLF | 1135 | Died |
| Psoas abscess | 50 | M | Farmer | Gampaha, Western | Rural, rice farming | None | Diabetes | August 2011 | Psoas abscess | YLF | 1132 | Recovered/relapsed |
| Liver abscess | 34 | M | Business man | Kurunegala, North Western | Urban, mower repair | None | Diabetes | December 2011 | Liver abscess | YLF | 1135 | Recovered |
| Psoas abscess/transverse myelitis | 21 | M | Driver | Polonnaruwa, North Central | Rural, unknown | Unknown | None | December 2011 | Psoas abscess | YLF | 1136 | Paraplegia |
| Cervical lymphadenitis/pharyngitis | 11 | M | Schoolboy | Badulla, Uva | Rural, unknown | None | None | July 2009 | Cervical node aspirate | YLF | 1136 | Recovered |
| Inguinal lymphadenitis | 53 | F | Business woman | Puttalum, North Western | Rural, unknown | None | Diabetes | March 2013 | Inguinal lymph node pus | BTFC | 1139 | Recovered |
| Cavitating pneumonia | 25 | M | Insurance salesman | Gampaha, Western | Urban, unknown | None | Diabetes | June 2013 | Sputum | YLF | 1141 | Recovered |
| Cerebral abscess | 16 | F | Schoolgirl | Gampaha, Western | Rural, rice farming | None | Severe dengue | August 2013 | Cerebral abscess | YLF | 1142 | Recovered |
| Liver abscess | 9 | F | Schoolgirl | Puttalum, North Western | Rural, river bathing | None | Thalassaemia | February 2014 | Liver abscess | YLF | 1146 | Recovered |
BTFC = Burkholderia thailandensis-like flagellum and chemotaxis; COPD = chronic obstructive pulmonary disease; F = female; M = male; MLST = multilocus sequence typing; YLF = Yersinia-like fimbrial.
*
MLST genotype of B. pseudomallei.