Prolonged high fever, sudden convulsions, conscious disorders
Patient N.C.T (54 years old, in Ninh Binh) works as a driver at a construction site in Phu Quoc.
About a week before being admitted to the hospital, the patient developed a high fever and headache. The patient self-treated and had injections but the type of medicine was unknown. Because the condition did not improve, the patient returned to his hometown to continue the examination.
After that, the patient suddenly experienced facial convulsions, loss of consciousness and was taken to a medical facility for emergency treatment. However, his consciousness continued to worsen, and he was transferred to the Emergency Department, National Hospital for Tropical Diseases.
Dr. Bui Duc Long Thanh (Department of Emergency) said that upon admission, the patient was in a state of lethargy and consciousness disorder. After that, local seizures continued to appear.
Test results recorded white blood cells of about 13,000 cells/mm3, CRP 106 mg/L and procalcitonin 5.4 ng/mL showing obvious inflammation and infection.
Notably, the patient has a very severe hyperglycemia, at times the blood sugar exceeds the measuring threshold of the machine. Doctors assess that blood sugar disorders, increased osmotic pressure and electrolyte disorders are factors that make the patient's neurological condition more complicated.
The subsequent blood culture results identified Burkholderia pseudomallei, the bacteria that caused Whitmore's disease.
In the process of assessing nerve damage, brain resonance imaging showed damage in the thalamus and scattered in the cerebral cortex. Faced with deteriorating consciousness, the patient had to have an endotracheal tube inserted, ventilated, and treated for infection and actively controlled metabolic disorders.
According to Dr. Thanh, the patient's developments are complicated due to Whitmore's infection on a background of severe blood sugar disorders, accompanied by neurological damage.
After nearly a month of intensive treatment, the patient's condition has improved significantly. However, the patient still needs to continue treatment sufficiently, strictly control blood sugar and monitor the recovery process.
Diabetes increases the risk of Whitmore developing severely
Whitmore is caused by Burkholderia pseudomallei bacteria, which exist naturally in soil and water. Bacteria can enter the body through wounds on the skin, respiratory or digestive tracts.
The disease can cause pneumonia, septicemia or abscesses in many organs. If the central nervous system is damaged, patients are at risk of severe progression and leaving sequelae in cognition and movement.
According to Dr. Bui Duc Long Thanh, diabetes is a risk factor that makes Whitmore easily develop severely, especially when blood sugar is poorly controlled. People with chronic kidney, liver, and lung diseases, prolonged alcohol use or immunodeficiency also need to be careful when exposed to soil and water.
In the rainy season, flooding causes people to be more exposed to mud and dirty water, thereby increasing the risk of Burkholderia pseudomallei exposure. People should limit direct contact, use boots and gloves when working in soil and water environments and cover wounds on the skin.
