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lüll Clinical characteristics and outcome of severe melioidosis requiring intensive care Chan KP; Low JG; Raghuram J; Fook-Chong SM; Kurup AChest 2005[Nov]; 128 (5): 3674-8STUDY OBJECTIVE: To describe the clinical characteristics and outcome of patients with severe melioidosis requiring intensive care. DESIGN: Retrospective chart review. SETTING: Two ICUs from a tertiary-care teaching hospital. PATIENTS: Twenty-seven adult ICU patients with microbiologically documented melioidosis. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The median age was 59 years with a male preponderance (26:1). Twenty patients (74%) had medical comorbidities, with diabetes mellitus being the most common (59.3%). Almost all patients (96.3%) were bacteremic. Twenty patients (74.1%) presented with pneumonia. Twenty patients (74.1%) were in septic shock, and 16 patients (59.3%) had ARDS. Twelve patients (44.4%) required hemodialysis. The patients had a median of three organ dysfunctions, and the median APACHE (acute physiology and chronic health evaluation) II score was 27. The overall mortality was 48.1%. Mortality among patients with septic shock was 60%. The median ICU length of stay for survivors and nonsurvivors was 11 days and 2 days, respectively. Multivariate analysis revealed that the number of organ dysfunctions is an independent predictor of mortality (odds ratio, 8.2; 95% confidence interval, 1.3 to 51.4). CONCLUSIONS: The outcome of severe melioidosis requiring intensive care is poor, with death being predicted by the number of organ dysfunctions.|APACHE[MESH]|Adult[MESH]|Aged[MESH]|Comorbidity[MESH]|Critical Care[MESH]|Female[MESH]|Humans[MESH]|Length of Stay[MESH]|Male[MESH]|Melioidosis/*diagnosis/epidemiology/therapy[MESH]|Middle Aged[MESH]|Multivariate Analysis[MESH]|Retrospective Studies[MESH]|Risk Factors[MESH]|Shock, Septic/mortality[MESH]|Survival Analysis[MESH] |