Articles Vol. 66 No. 2 04/03/2025

6. TREATMENT RESULTS AND SOME FACTORS RELATED TO DEATH AND SEVERE HOSPITALIZATION OF WHITMORE CHILDREN'S PATIENTS AT THE NATIONAL CHILDREN’S HOSPITAL FROM 2017-2023

Le Thi Yen1,2, Nguyen Van Lam1,2, Tran Thanh Duong3,4, Phan Thi Thu Chung1,2, Hoang Thi Bich Ngoc1,2, Tran Minh Dien1,2
1 National Children’s Hospital
2 Bệnh viện Nhi Trung ương
3 National Institute of Nutrition
4 Viện Dinh dưỡng Quốc gia
Corresponding author: Bslethiyen2111@gmail.com
DOI: 10.52163/yhc.v66i2.2047
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Keywords
Whitmore in children sepsis septic shock
Abstract

Objectives: Evaluate treatment results and some factors related to death and severe hospitalization of Whitmore children’s patients at National Children’s Hospital from 2017 to 2023.

Method: Retrospective and prospective descriptive study on 45 children diagnosed with Whitmore treated at the National Children’s Hospital from January 1, 2017 to December 31, 2023.

Results: There were 45 Whitmore pediatric patients. The number of pediatric patients ≤ 5 years old is 26 (57.8%); the male/female ratio is 2/1. Empirically correct initial antibiotics were 28.9%. The average inpatient stay was 21 ± 16 days (2-61 days). Surgical intervention was 64.4%, mainly lymph node abscess extraction or surgical drainage to drain lymph node abscess 82.8%. The cure rate was 84.4% (38/45); mortality was 15.6% (7/45), all 7 of these cases were septicemia.  Some factors related to death and serious illness include: male children, age over 5 years old, clinical diseases such as sepsis, septic shock, decreased white blood cell count, decreased platelet count, CRP is over 98 mg/L and the number of specimens isolated in each case is from 2 or more types of samples.

Conclusions: Initial antibiotic prescription according to experience in Whitmore pediatric patients is still low. The mortality rate is high, especially in pediatric patients with sepsis and septic shock.

References
[1]
1. Chakravorty A, Heath C, Melioidosis: An updated review, Aust J Gen Pract, 2019, 48 (5), 327-332. Google Scholar
[2]
2. Chewapreecha C, Holden M.T.G, Vehkala M et al, Global and regional dissemination and evolution of Burkholderia pseudomallei, Nat Microbiol, 2017, 2, 16263. Google Scholar
[3]
3. Phuong D.M, Trung T.T, Breitbach K et al, Clinical and microbiological features of melioidosis in northern Vietnam, Transactions of the Royal Society of Tropical Medicine and Hygiene, 2008, 102, S30-S36. Google Scholar
[4]
4. Arjun C, Moritz B, Thyl M et al, Improving Treatment and Outcomes for Melioidosis in Children, Northern Cambodia, 2009-2018, Emerging infectious diseases, 2021, 27 (4). Google Scholar
[5]
5. Bộ Y tế, Quyết định số 6101/QĐ-BYT, ngày 30 tháng 12 năm 2019, về việc ban hành Hướng dẫn chẩn đoán, điều trị bệnh Whitmore. Google Scholar
[6]
6. Wiersinga W.J, Virk H.S, Torres A.G et al, Melioidosis, Nat Rev Dis Primers, 2018, 4 (1), 1-22. Google Scholar
[7]
7. Currie B.J, Mayo M, Ward L.M et al, The Darwin Prospective Melioidosis Study: a 30-year prospective, observational investigation, Lancet Infect Dis, 2021, 21 (12), 1737-1746. Google Scholar
[8]
8. Ian G, Vibooshini G, Mark C et al, Melioidosis: Laboratory Investigations and Association with Patient Outcomes, The American journal of tropical medicine and hygiene, 2021, 106 (1). Google Scholar
[9]
9. Philippa K, Simon S, Linda W et al, Clinical Utility of Platelet Count as a Prognostic Marker for Melioidosis, The American journal of tropical medicine and hygiene, 2019, 100 (5). Google Scholar
[10]
10. Raviraj M, Poornima B, Anil K.V et al, Risk Factors for Mortality in Melioidosis: A Single-Centre, 10-Year Retrospective Cohort Study, TheScientificWorldJournal, 2021. Google Scholar