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Volume 27, Number 6—June 2021
Dispatch

Melioidosis in Children, Brazil, 1989–2019

Rachel Ximenes Ribeiro Lima1Comments to Author  and Dionne Bezerra Rolim1
Author affiliations: Municipal Department of Health, Fortaleza, Brazil (R.X.R. Lima); University of Fortaleza Medical School (R.X.R. Lima, D.B. Rolim); Ceará State University, Fortaleza (D.B. Rolim)

Main Article

Table 1

Clinical definitions in study of melioidosis in children, Brazil, 1989–2019*

Term Definition
Suspected melioidosis
All patients with suspected melioidosis must have epidemiologic exposure at any time, recent or not, associated with >1 of the following criteria: acute febrile illness and respiratory symptoms suggestive of community pneumonia that do not improve with conventional antimicrobial treatment (β-lactam antimicrobial drugs); febrile disease that progresses with systemic inflammatory response syndrome, severe sepsis, or septic shock;
prolonged fever of unknown etiology or signs and symptoms similar to tuberculosis that do not respond to tuberculosis treatment; or soft tissue infection (e.g. cutaneous ulcers/abscesses, cellulite, or fasciitis) of chronic evolution (i.e. months) with no response to conventional antimicrobial treatment (e.g. oxacillin, ampicillin associated to sulbactam, or cefalexin).
Confirmed melioidosis
All patients with confirmed melioidosis must meet laboratory (bacteriologic confirmation by microbiological culture or positive PCR) or
clinical-epidemiologic criteria (exposure to the same risk situation as patients with laboratory-confirmed melioidosis). Patients with confirmed melioidosis must have signs and symptoms that are compatible with melioidosis and not attributable to a different cause.
Severe disease Patients with severe melioidosis have clinical signs and symptoms and a high risk for death caused by pneumonia, sepsis, or septic shock.

*These criteria were defined by references (5,7).

Main Article

References
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  2. Limmathurotsakul  D, Golding  N, Dance  DAB, Messina  JP, Pigott  DM, Moyes  CL, et al. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol. 2016;1:15008. DOI
  3. Rolim  DB, Vilar  DCFL, Sousa  AQ, Miralles  IS, de Oliveira  DC, Harnett  G, et al. Melioidosis, northeastern Brazil. Emerg Infect Dis. 2005;11:145860. DOIPubMed
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  11. Smith  S, Stewart  JD, Tacon  C, Archer  N, Hanson  J. Children with melioidosis in Far North Queensland are commonly bacteraemic and have a high case fatality rate. Commun Dis Intell Q Rep. 2017;41:E31821.PubMed
  12. Currie  BJ, Jacups  SP. Intensity of rainfall and severity of melioidosis, Australia. Emerg Infect Dis. 2003;9:153842. DOIPubMed
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Main Article

1These authors contributed equally to this article.

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Page updated: May 18, 2021
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