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Objective: To investigate the clinical features class Burkholderia cepacia sepsis, summed up the experience of diagnosis and treatment to improve the diagnosis and treatment. Methods: A retrospective analysis of the First Affiliated Hospital of Guangxi Medical University from October 2006 to December 2008 were 4 cases of melioidosis Burkholderia sepsis clinical features, imaging findings, diagnosis and treatment and outcome. Results: (1) 4 patients were male, local farmers, with an average age of 41.75 ± 1.76 years old, 2 patients had a history of trauma and contact with contaminated pond water, 2 patients had a history of exposure to soil. (2) all patients with acute onset, manifested as sepsis, chills, fever, anemia, weight loss and other symptoms concomitant parts of abscess, 1 case of lung abscess and right leg purulent infection of the skin, and 1 case as the liver, spleen, pancreas, mediastinal abscess, one case of the right facial soft tissue purulent infection. (3) Laboratory tests: (1) 3 patients the total number of white blood cells [(11.62 ± 0.49) × 10 9 / L] and neutral count [(8.31 ± 0.40) × 10 9 / L] increased slightly, and 1 patient leukocyte the total number of neutral count. ② 4 patients have an erythrocyte sedimentation rate increased (63.5 ± 2.69) mm / h, C-reaction protein and blood (154.5 ± 3.96) mg / L, 3 patients with liver dysfunction. Three patients had elevated blood sugar, but denied a history of diabetes. (4) imaging: pulmonary manifestations of multiple lobe or lung segment patchy or infiltrative shadow with partial fusion, some nodules of varying sizes two on lung lesions. The extrapulmonary manifestations main parts of the abscess of the liver, spleen, skin and soft tissue. (5) after repeated blood cultures or pus culture culture a class Burkholderia cepacia is a basis for diagnosis. (6) 4 patients first diagnosed all misdiagnosed, the the common misdiagnosis disease pneumonia, tuberculosis, sepsis. (7) The bacterium sensitive carbapenem beta-lactam or beta-lactamase inhibitors. The other three cases of beta-lactam or beta-lactamase inhibitors onset patients require the use of carbapenem Thai markedly. These patients are in use 3-4 days after treatment with antibiotics, the body temperature gradually decreased, intravenous drug use for up to four to eight weeks, the total course of 4 to 6 months. Conclusion: (1) Guangxi presence of human melioidosis, mainly distributed in the southern Guangxi and Guangxi along the southwestern occurred in rainy and windy season (July to November). Mainly in young men, farmers, patients with long-term damage to the skin and a history of contact with sewage or dust. (2) in patients with acute onset, chills, fever symptoms appear deep and shallow parts of the organs (lung, liver, spleen, and skin) and multiple organ damage multiple abscess, lung involvement is the most common, easy The diagnosis of tuberculosis and other diseases. White blood cells and neutrophils can be increased, the hemoglobin decreased markedly, In addition, most patients with difficult to control high blood sugar, blood or pus can be repeatedly cultured pathogens. (3) the bacterium is sensitive to the antibiotic carbapenem beta-lactam or beta-lactamase inhibitors. 1 patient requires the use of the carbapenem Thai treatment was markedly, and the other three cases if the use of beta-lactam or beta-lactamase inhibitors (ceftazidime or cefoperazone / sulbactam) markedly. Patients are treated with antibiotics after 3-4 days the temperature gradually decreased, intravenous drug use up to 4 to 8 weeks after systemic abscess gradually absorbed the total course of 4 to 6 months. (4) the early abscess drainage in the treatment, high blood sugar actively control blood sugar, is one of the key to successful treatment.
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