Fever in a returning traveler: A case and literature review of melioidosis

Arya, Akanksha; Shaikh, Hamadullah; Weber, Devin; Pettengill, Matthew A.; Moss, Sean

doi:10.1016/j.idcr.2021.e01340

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Furthermore, environmental air sampling did not detect aerosolization of B. pseudomallei during routine laboratory procedures. We recently had a patient with cultures positive for B. pseudomallei [ 43 ], and three technologists were exposed outside of a BSC; one of the technologists ended up in the hospital because of it, not for B. pseudomallei infection, but rather, an allergic reaction to prophylactic TMP-SMX (none had infections or seroconverted). And then, of course, we followed the select agent rules and did a lot of paperwork.…”

Section: Other Studiesmentioning

confidence: 99%

Clinical Microbiology in 2021: My Favorite Studies about Everything Except My Least Favorite Virus

Pettengill

2022

Clinical Microbiology Newsletter

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Section: Other Studiesmentioning

confidence: 99%

Clinical Microbiology in 2021: My Favorite Studies about Everything Except My Least Favorite Virus

Pettengill

2022

Clinical Microbiology Newsletter

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“…Burkholderia pseudomallei is a Gram-negative pathogen that is responsible for melioidosis, which is endemic to areas of Southeast Asia, Northern Queensland, and the Northern Territory of Australia [1,2]. Additionally, there is increasing evidence that melioidosis exists in other areas, including the United States [3] and Bangladesh [4]. This disease is considered a great mimicker as it presents with a varied range of disease manifestations.…”

Section: Introductionmentioning

confidence: 99%

Type VI Secretion System Accessory Protein TagAB-5 Promotes Burkholderia pseudomallei Pathogenicity in Human Microglia

Lohitthai,

Rungruengkitkun,

Jitprasutwit

et al. 2023

Biomedicines

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Central nervous system (CNS) melioidosis caused by Burkholderia pseudomallei is being increasingly reported. Because of the high mortality associated with CNS melioidosis, understanding the underlying mechanism of B. pseudomallei pathogenesis in the CNS needs to be intensively investigated to develop better therapeutic strategies against this deadly disease. The type VI secretion system (T6SS) is a multiprotein machine that uses a spring-like mechanism to inject effectors into target cells to benefit the infection process. In this study, the role of the T6SS accessory protein TagAB-5 in B. pseudomallei pathogenicity was examined using the human microglial cell line HCM3, a unique resident immune cell of the CNS acting as a primary mediator of inflammation. We constructed B. pseudomallei tagAB-5 mutant and complementary strains by the markerless allele replacement method. The effects of tagAB-5 deletion on the pathogenicity of B. pseudomallei were studied by bacterial infection assays of HCM3 cells. Compared with the wild type, the tagAB-5 mutant exhibited defective pathogenic abilities in intracellular replication, multinucleated giant cell formation, and induction of cell damage. Additionally, infection by the tagAB-5 mutant elicited a decreased production of interleukin 8 (IL-8) in HCM3, suggesting that efficient pathogenicity of B. pseudomallei is required for IL-8 production in microglia. However, no significant differences in virulence in the Galleria mellonella model were observed between the tagAB-5 mutant and the wild type. Taken together, this study indicated that microglia might be an important intracellular niche for B. pseudomallei, particularly in CNS infection, and TagAB-5 confers B. pseudomallei pathogenicity in these cells.

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Travel-associated melioidosis: a narrative review

Norman

Chen

2023

Journal of Travel Medicine

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Background: Melioidosis, caused by Burkholderia pseudomallei, may be considered a neglected tropical disease which remains underdiagnosed in many geographical areas. Travelers can act as sentinels of disease activity and data from imported cases may help complete the global map of melioidosis. Methods: A literature search for imported melioidosis for the period 2016-2022 was performed in PubMed and Google Scholar. Results: In total, 137 reports of melioidosis associated with travel were identified. The majority were males (71%) and associated with exposure in Asia (77%) (mainly Thailand, 41%, and India, 9%). A minority acquired the infection in the Americas-Caribbean area (6%), Africa (5%) and Oceania (2%). The most frequent comorbidity was diabetes mellitus (25%) followed by underlying pulmonary, liver or renal disease (8%, 5% and 3%, respectively). Alcohol/tobacco use were noted for 7 and 6 patients, respectively (5%). Five patients (4%) had associated non-HIV related immunosuppression and 3 patients (2%) had HIV infection. One patient (0.8%) had concomitant COVID-19. A proportion (27%) had no underlying diseases. The most frequent clinical presentations included pneumonia (35%), sepsis (30%), and skin/soft tissue infections (14%). Most developed symptoms <1 week after return (55%) and 29% developed symptoms >12 weeks after. Ceftazidime and meropenem were the main treatments used during the intensive intravenous phase (52% and 41% of patients, respectively) and the majority (82%) received co-trimoxazole alone/combination, for the eradication phase. Most patients had a favorable outcome/survived (87%). The search also retrieved cases in imported animals or cases secondary to imported commercial products. Conclusions: As post-pandemic travel soars, health professionals should be aware of the possibility of imported melioidosis with its diverse presentations. Currently no licensed vaccine is available so prevention in travelers should focus on protective measures (avoiding contact with soil/stagnant water in endemic areas). Biological samples from suspected cases require processing in biosafety level 3 facilities.

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Fever in a returning traveler: A case and literature review of melioidosis

Cited by 3 publications

References 10 publications

Clinical Microbiology in 2021: My Favorite Studies about Everything Except My Least Favorite Virus

Clinical Microbiology in 2021: My Favorite Studies about Everything Except My Least Favorite Virus

Type VI Secretion System Accessory Protein TagAB-5 Promotes Burkholderia pseudomallei Pathogenicity in Human Microglia

Travel-associated melioidosis: a narrative review

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