2019Clinical Infection in PracticeOpen access

Melioidosis case series

Blair Merrick, Tara L. Jones, Edmund L. C. Ong, David Price, Ulrich Schwab

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Abstract

Melioidosis is a potentially fatal infection caused by Burkholderia pseudomallei , a bacterium endemic to certain tropical and subtropical world regions. It most frequently enters the body through small abrasions on the feet or lower limbs when individuals walk barefoot, or in open footwear, through contaminated wet or muddy environments. We report on three female cases successfully treated for melioidosis within the Newcastle upon Tyne NHS Hospitals over a 12-month period; a 52-year-old with a mediastinal abscess, a 38-year-old with an intra-cerebral abscess, and a 69-year-old with pneumonia and bacteraemia. Two patients were diabetic, the latter with established microvascular complications, but the third patient had no immunosuppressive risk factor identified. All had recently travelled to Thailand, although one remained solely within the confines of her holiday resort and another did not leave the city of Pattaya. Clinicians must remain vigilant to the potential for imported cases of melioidosis into the UK in travellers returning from endemic areas, such as Southeast Asia.

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Melioidosis is a potentially fatal infection caused by Burkholderia pseudomallei , a bacterium endemic to certain tropical and subtropical world regions. It most frequently enters the body through small abrasions on the feet or lower limbs when individuals walk barefoot, or in open footwear, through contaminated wet or muddy environments. We report on three female cases successfully treated for melioidosis within the Newcastle upon Tyne NHS Hospitals over a 12-month period; a 52-year-old with a mediastinal abscess, a 38-year-old with an intra-cerebral abscess, and a 69-year-old with pneumonia and bacteraemia. Two patients were diabetic, the latter with established microvascular complications, but the third patient had no immunosuppressive risk factor identified. All had recently travelled to Thailand, although one remained solely within the confines of her holiday resort and another did not leave the city of Pattaya. Clinicians must remain vigilant to the potential for imported cases of melioidosis into the UK in travellers returning from endemic areas, such as Southeast Asia.

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Available abstract

Melioidosis is a potentially fatal infection caused by Burkholderia pseudomallei , a bacterium endemic to certain tropical and subtropical world regions. It most frequently enters the body through small abrasions on the feet or lower limbs when individuals walk barefoot, or in open footwear, through contaminated wet or muddy environments. We report on three female cases successfully treated for melioidosis within the Newcastle upon Tyne NHS Hospitals over a 12-month period; a 52-year-old with a mediastinal abscess, a 38-year-old with an intra-cerebral abscess, and a 69-year-old with pneumonia and bacteraemia. Two patients were diabetic, the latter with established microvascular complications, but the third patient had no immunosuppressive risk factor identified. All had recently travelled to Thailand, although one remained solely within the confines of her holiday resort and another did not leave the city of Pattaya. Clinicians must remain vigilant to the potential for imported cases of melioidosis into the UK in travellers returning from endemic areas, such as Southeast Asia.

Key concepts: Melioidosis, Burkholderia pseudomallei, Medicine, Southeast asia, Abscess, Pneumonia, Pediatrics, Surgery

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