Staphylococcus Aureus Colonization on an Erythrodermic Psoriasis Patient

Skin plays an important role as the physical barrier and first-line immunological defense against dangerous stimuli, including bacteria. Erythroderma is a condition of excessive skin irritation causing extensive erythema and desquamation. Erythroderma itself is caused by various underlying conditions, one of them is psoriasis vulgaris. In erythroderma, there is an extensive disruption of physical barrier leading to the exposure of various bacteria, including Staphylococcus aureus. In human, this bacteria can either colonize or infect the host if exposed to open wound. It is essential to determine this as it will affect the necessity of administering antibiotics. Laboratory examinations such as complete blood count, Gram staining, and culture can help to determine the status of this bacteria. A correlation between clinical features and laboratory examinations is paramount in deciding patient management

Emergence of melioidosis in Indonesia and today’s challenges

A recent modeling study estimated that there could be as many as 20,000 human melioidosis cases per year in Indonesia, with around 10,000 potential deaths annually. Nonetheless, the true burden of melioidosis in Indonesia is still unknown. The Indonesia Melioidosis Network was formed during the first melioidosis workshop in 2017. Here, we reviewed 101 melioidosis cases (99 human and two animal cases) previously reported and described an additional 45 human melioidosis cases. All 146 culture-confirmed cases were found in Sumatra (n = 15), Java (n = 104), Kalimantan (n = 15), Sulawesi (n = 11) and Nusa Tenggara (n = 1). Misidentification of Burkholderia pseudomallei was not uncommon, and most cases were only recently identified. We also evaluated clinical manifestations and outcome of recent culture-confirmed cases between 2012 and 2017 (n = 42). Overall, 15 (36%) cases were children (age ; 15 years) and 27 (64%) were adults (age ≥15 years). The overall mortality was 43% (18/42). We conducted a survey and found that 57% (327/548) of healthcare workers had never heard of melioidosis. In conclusion, melioidosis is endemic throughout Indonesia and associated with high mortality. We propose that top priorities are increasing awareness of melioidosis amongst all healthcare workers, increasing the use of bacterial culture, and ensuring accurate identification of B. pseudomalleiand diagnosis of melioidosis