Prospective observational study of the frequency and features of intra-abdominal abscesses in patients with melioidosis in northeast Thailand
Maude RR., Vatcharapreechasakul T., Ariyaprasert P., Maude RJ., Hongsuwan M., Yuentrakul P., Limmathurotsakul D., Koh GCKW., Chaowagul W., Day NPJ., Peacock SJ.
Retrospective case series from Thailand have reported the presence of intra-abdominal abscesses in around half of patients with melioidosis, a much higher rate than our clinical experience would suggest. We performed a prospective, observational study of 230 adult patients with culture-confirmed melioidosis in which all patients underwent abdominal ultrasound. One or more abscesses were detected in the liver and/or spleen in 77 (33%) cases. These were often multiple (70%, 31/44 in hepatic abscesses and 88%, 50/57 in splenic abscesses) and clinically silent (27% of cases with abscesses presenting with abdominal pain). The mortality rate at 4 weeks post-discharge was lower in patients who were abscess-positive vs abscess-negative (10%, 8/77 vs 20%, 31/153). © 2012 Royal Society of Tropical Medicine and Hygiene.