Whitmore's disease

Whitmore is an acute dangerous infectious disease caused by the gram-negative bacterium Burkholderia pseudomallei.

This article is expertly advised by Dr. Le Minh Lan Phuong, Head of Medical Examination Department, Children's Hospital 1 (HCMC).

The gram-negative bacterium Burkholderia pseudomallei lives on water surfaces and in soil, especially mud.

Path of infection

- Infection is mainly due to contact with bacteria in contaminated soil through skin wounds.

- A few people inhale dust, water droplets or ingest water containing bacteria, so they are more likely to be transmitted through the digestive tract.

- However, it is not transmitted from person to person.

- Disease cases only occur sporadically and do not break out into epidemics or pandemics.

Expression

- There is no specific clinical or pathological syndrome.

- Symptoms are similar to other diseases such as tuberculosis, sepsis, prolonged fever with many abscesses on the body.

- Accurate diagnosis of the disease must be based on tests to isolate and identify bacteria in blood, pus, sputum, urine, or cerebrospinal fluid samples.

- The incubation period is usually from one to 21 days, with an average of 9 days.

- The severity of the disease depends on the infection, which can cause prolonged fever, cough, chest pain, swelling of muscles and joints, respiratory failure...

- In children:

+ About 35% have symptoms of purulent inflammation of the parotid salivary glands.

+ 65% in other forms such as high fever, pneumonia, abscesses in the spleen and kidney.

+ Can also be localized as infected foci on the skin, especially in the head, face and neck areas.

+ Severe complications can cause septic shock leading to death.

- In adults:

+ Most have symptoms of pneumonia with sepsis and abscesses on the skin.

+ Some also show signs of internal abscesses such as liver and spleen abscesses, cystitis, arthritis or meningitis.

Risk group

- Middle age.

- People with diabetes.

- Alcoholics.

- People with lung disease.

- People with chronic kidney disease.

- People at risk of contact with dirty mud containing bacteria.

Treatment

- Use antibiotics of the ceftazidime or carbapenem group, cotrimoxazole at high doses continuously for at least 2-4 weeks.

- Then use antibiotics for another 3-6 months.

Mortality rate

- Infected people have a mortality rate of 40-60%.

- In case of acute infection, death can occur within a week of the onset of illness.

- If not treated with the right dose, correct regimen and close monitoring, the disease can easily relapse, the patient's health will gradually decline and death may occur.

- The process of monitoring and treating the disease is long and expensive, so many patients have given up.

Prevention

- Ensure personal hygiene.

- Regularly wash your hands with soap and clean water, especially before and after preparing food, after going to the toilet, after working in the fields, and before eating.

- Eat cooked food and drink cooled boiled water to ensure food hygiene and safety.

- Do not slaughter or eat sick or dead animals, livestock or poultry.

- Limit direct contact with dirty soil and water, especially in heavily polluted areas.

- Do not bathe, swim, or dive in ponds, lakes, and rivers at/near polluted places.

- Use labor protection equipment (shoes, boots, gloves...) for people who often work outdoors and come into contact with dirty soil and water.

- When there are open wounds, ulcers or burns, avoid contact with potentially contaminated soil or water. If contact is necessary, use a waterproof bandage and it should be washed to ensure hygiene.

- People with underlying diseases such as diabetes, chronic liver, kidney, lung disease, immunodeficiency... need to be cared for and protected to prevent infections.

- When suspected of being infected, go to a medical facility for advice, examination, detection and timely treatment.

* SOURCE: https://vnexpress.net/benh-whitmore-4655093.html