| melioidosis is an infection with the gram-negative bacillus Burkholdria pseudomallei, previous known as pseudomonas pseudomallei. We present a case report of a man with Non-Hodgkin's lymphoma, who after visiting indonesia presented himself with a urosepsis, with positive cultures to B. pseudomallei. melioidosis is endemic in areas of southeast asia and the northern part of australia. infection with the B. pseudomallei has a high mortality rate. Diagnosis can be made on the basis of cultures, the bacteria grow on standard media. Treatment should be based up on sensitivity studies. The optimum duration of therapy and choice of antibiotics remain to be determined. Due to the increase in travel, the infection will be seen more frequently in other parts of the world. ( info) |
| We report herein a patient with pulmonary melioidosis, whose initial chest roentgenogram revealed only a pleural mass. The patient had not been in a zone endemic for melioidosis during the previous 15 months. We stress the importance of including melioidosis in the differential diagnosis of pleural lesions, and of considering this diagnosis in any patient who has been in an endemic zone at any time in the past. ( info) |
3/151. An indigenous melioidosis: a case report. melioidosis is a rare but potentially fatal infectious disease in taiwan, although it has been endemic in Southeast asia, especially northeast thailand, and northern australia. In this article, we report a male diabetes with fulminant pneumonia, and septicemia caused by burkholderia pseudomallei without traveling abroad before this episode. Productive cough and intermittent chills, high fever for one week, followed by progressively deteriorating dyspnea, shock, disturbed consciousness status were the major presentations. blood culture grew B. pseudomallei on the fifth admission day. Unfortunately, the patient died on the 9th admission day, despite intensive care and the broad-spectrum antimicrobial regimen used. ( info) |
4/151. Surgical presentation of melioidosis in india. BACKGROUND: melioidosis, the disease caused by burkholderia pseudomallei, is common in Southeast asia. It has also been reported from india, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites. methods: All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated. RESULTS: Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed. CONCLUSION: melioidosis is under-diagnosed in india, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent. ( info) |
5/151. melioidosis with adrenal gland abscess. We report a case of melioidosis with left adrenal gland abscess in a 51-year-old man from taiwan who traveled to Rangoon, Burma for a four-day tour on July 15, 1997. The patient developed fever and left upper abdominal pain upon returning to taiwan on July 19, 1997. Ten days after returning to taiwan, he was admitted to Chang Gung Memorial Hospital in Keelung, taiwan and blood culture on admission was positive for burkholderia pseudomallei. Computerized tomography of the abdomen revealed left adrenal gland swelling and suppuration. Treatment with parenteral ceftazidime and cotrimoxazole for three weeks followed by two months of oral cotrimoxazole cured the infection. The patient remained asymptomatic at 12 months follow-up. ( info) |
| melioidosis is a protean disease caused by burkholderia pseudomallei. It is rare in the UK and is generally only seen in patients with a travel history to endemic areas such as thailand, singapore and malaysia. Cases may present with disseminated bacteraemic, non-disseminated bacteraemic, multi-focal bacteraemic or localized disease. Subclinical infections also occur. Following acquisition of the organism a patient may remain asymptomatic for several years before infection becomes clinically apparent. Factors such as diabetes, renal failure or other causes for a decrease in host immunity may precipitate the appearance of overt disease. The current treatment choice for severe melioidosis is parenteral ceftazidime followed by oral amoxycillin-clavulanic acid or a combination of co-trimoxazole, doxycycline and chloramphenicol. We report a case of melioidosis in a 59-year-old male diabetic from bangladesh who initially responded to piperacillin-tazobactam but was changed to ceftazidime when a definitive diagnosis was made. His condition deteriorated on the latter antibiotic. He subsequently responded to imipenem. The patient's long-term outcome is still not known. ( info) |
7/151. melioidosis, an environmental and occupational hazard in thailand. melioidosis is a tropical environmental hazard that causes acute and chronic pulmonary disease, abscesses of the skin and internal organs, meningitis, brain abscess and cerebritis, and acute fulminant rapidly fatal sepsis. It is more common among adults, individuals with diabetes, and individuals with chronic renal disease, but it can occur in normal hosts and children. Burkholderia pseudomellei is the most prevalent cause of community-acquired pneumonia, liver and splenic abscess, and sepsis in northeastern thailand. melioidosis can reactivate years after primary infection and result in chronic or acute life-threatening disease. With increasing worldwide travel and migration, patients may present in nonendemic countries with reactivation melioidosis decades after leaving an endemic region. We discuss seven selected patients presenting with this disease to a tertiary care facility in Bangkok between 1995 and 1997. awareness should allow early diagnosis and treatment, which can lead to decreased morbidity and mortality. ( info) |
8/151. Meliodosis presenting as encephalitis. Meliodosis is an infectious disease caused by pseudomonas pseudomellei, an organism that is common in South-East asia, the Caribbean and northern australia. In the author's case report the disease presented as an encephalitic illness with fever and epileptic fits in a five-year-old Chinese boy. The case illustrates one of the many forms of this illness. The patient, though very ill, made an excellent recovery. The report discusses the manifestations, diagnosis and management of Meliodosis. ( info) |
| melioidosis is a tropical disease caused by burkholderia pseudomallei, which is common in southeast asia and australia, but which is rarely diagnosed in scandinavia. An increasing number of cases are being reported among tourists to infected areas. We report the first Finnish case of melioidosis, which presented as urinary tract infection in a previously healthy male tourist. ( info) |
| INTRODUCTION: burkholderia pseudomallei infection, the great mimicker of infectious diseases, has protean clinical manifestations. CLINICAL PICTURE: A 37-year-old man who presented with community-acquired pneumonia affecting the right upper lobe had unremitting fever. bronchoscopy showed an endobronchial mass in the right upper lobe bronchus. TREATMENT: Intravenous ceftriaxone and oral erythromycin, with empiric antituberculous treatment added later. This was subsequently switched to intravenous ceftazidime and oral doxycycline after the diagnosis was made. OUTCOME: There was resolution of the endobronchial mass. CONCLUSION: This case illustrates a unique and unreported presentation of melioidosis. ( info) |