Dural sinus thrombosis in melioidosis: the first case report.

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dc.contributor.authorNiyasom, Suchadaen_US
dc.contributor.authorSithinamsuwan, Pasirien_US
dc.contributor.authorUdommongkol, Chesdaen_US
dc.contributor.authorSuwantamee, Jithanormen_US
dc.date.accessioned2009-05-27T18:05:45Z
dc.date.available2009-05-27T18:05:45Z
dc.date.issued2006-02-04en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractMelioidosis which is infection with Burkholderia pseudomallei, is an important cause of sepsis in India, southeast Asia and northern Australia. Mortality is high and treatment is problematic. Neurological melioidosis is unusual but meningoencephalitis, encephalomyelitis and brain microabscess can occur Dural sinus thrombosis is not an uncommon cerebrovascular disorder with various etiologies. Hypercoagulable state, pregnancy, dehydration, certain blood dyscrasia and contraceptive pills are common causes however meningitis and local head & neck infections may lead to this condition. Dural sinus thrombosis complicating septicemic melioidosis has never been reported. The authors report a 42-year-old Thai man suffering from septicemic melioidosis with dural sinus thrombosis. He had high fever, headache, left hemiparesis, focal seizure and increased intracranial pressure. Diabetes and mild alcoholic cirrhosis were diagnosed in this admission. CT scan, MRI brain and MRV revealed superior saggital sinus thrombosis with complicating venous infarction over right posterior parietal lobe. Hemoculture demonstrated Burkholderia pseudomallei and CSF was acellular Investigations for causes of dural sinus thrombosis were all negative. This patient gradually improved after treatment with ceftazidime, antiepileptic drug and heparin without clinical recurrence. Neuromelioidosis is a rare syndrome that may present as brain abscess, encephalitis or meningoencephalitis. The authors report dural sinus thrombosis associated with septicemic melioidosis. The authors' hypothesis of venous thrombosis in the presented case is sepsis induced hypercoagulable state. Physicians should be aware of cerebral venous thrombosis in case of suspicious melioidosis with neurological involvement. Prompt treatment with intravenous heparin and antibiotic is potentially effective.en_US
dc.description.affiliationDivision of Neurology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.en_US
dc.identifier.citationNiyasom S, Sithinamsuwan P, Udommongkol C, Suwantamee J. Dural sinus thrombosis in melioidosis: the first case report. Journal of the Medical Association of Thailand. 2006 Feb; 89(2): 242-7en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/38445
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdulten_US
dc.subject.meshCeftazidime --therapeutic useen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeparin --therapeutic useen_US
dc.subject.meshHumansen_US
dc.subject.meshMagnetic Resonance Angiography --methodsen_US
dc.subject.meshMaleen_US
dc.subject.meshMelioidosis --complicationsen_US
dc.subject.meshPhenytoin --therapeutic useen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshSeverity of Illness Indexen_US
dc.subject.meshSinus Thrombosis, Intracranial --diagnosisen_US
dc.subject.meshTomography, X-Ray Computed --methodsen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleDural sinus thrombosis in melioidosis: the first case report.en_US
dc.typeCase Reportsen_US
dc.typeJournal Articleen_US
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