ReviewNew microbes and new infections2025
Tunnel sign on magnetic resonance imaging in neuromelioidosis: A systematic literature review.
Review in New microbes and new infections, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Whole Genome Sequencing and Comparative Genomics of the Emerging PathogenPathogens (Basel, Switzerland) · 2025Pooled it
- Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Neuromelioidosis can present with abscesses, meningitis, or encephalomyelitis, but can be missed on blood culture. Linear enhancement of the corticospinal tract (white matter motor pathway) on magnetic resonance imaging (MRI) in the form of a 'tunnel sign' is an essential clue for early diagnosis of neuromelioidosis. This systematic review (SR) explores the clinical profile and outcomes of neuromelioidosis patients with tunnel signs. Methods: An SR was conducted to look for articles reporting individual details of neuromelioidosis patients with tunnel signs (reported or present on published images) on MRI. This review followed PRISMA guidelines and was prospectively registered with PROSPERO (CRD42024597199). After title-abstract and full-text screening, clinical profile and outcome data were extracted and analysed. Results: Thirty cases (22 articles) with tunnel signs on MRI were included after screening 2985 articles. The traditional risk factors (diabetes mellitus, alcohol intake, steroids, etc.) for melioidosis were present in only 23 % (5/22) of patients. Limb weakness (89 %, 24/27) and cranial nerve involvement (46 %, 11/24) were commonly seen at presentation. Blood and cerebrospinal fluid (CSF) cultures for Conclusion: In melioidosis-endemic areas with access to MRI, recognising the link between the presence of a tunnel sign and neuromelioidosis is crucial to initiate early adequate therapy.
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