Melioidosis: Recrudescence with a Strain Resistant to Multiple Antimicrobials<sup>1</sup>

Cf, Shaefer; Rc, Trincher; Jp, Rissing

doi:10.1164/arrd.1983.128.1.173

Cited by 12 publications

(3 citation statements)

References 14 publications

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“…Although tetracycline or trimethoprim-sulfamethoxazole has been suggested as primary therapy for melioidosis, no satisfactory treatment regimens have been established (15). P. pseudomallei is not only resistant to therapy with many antibiotics but clinically may fail to respond to those drugs to which it is susceptible in vitro (13,26). The present case reveals good correlation between clinical responsiveness and the in vitro results with amikacin.…”

Section: Onpgmentioning

confidence: 56%

“…This therapy appeared to be effective and resulted in defervescence. Although cloudy pneumonia of both lungs persisted as evidenced by chest radiograph, the patient was discharged on 26 October. Because of positive microhemagglutination assay for Treponema pallidum, she was treated with penicillin G benzathine three times before discharge (2.4 million U per week).…”

Section: Case Reportmentioning

confidence: 99%

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Pseudomonas pseudomallei infection from drowning: the first reported case in Taiwan

Liao¹,

Wu²,

Lee³

et al. 1985

J Clin Microbiol

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We report a case of Pseudomonas pseudomallei infection, in which the patient acquired the bacteria by aspiration of river water after a drowning incident near Manila, the Philippines. The pulmonary form of melioidosis was noted at the onset, but septicemia developed at a later stage. Positive blood cultures were obtained 17 days after the accident. The patient was treated successfully with a combination of amikacin and cephalothin. This is the first report of P. pseudomallei infection documented in Taiwan. Melioidosis, a rapidly fatal granulomatous disease caused by Pseudomonas pseudomallei, was first described by Whitmore and Krishnaswami in 1912 (29). It was observed that human infections with P. pseudomallei occurred almost exclusively in the between latitude 200 north and latitude 20°s outh. It is endemic in Southeast Asia (Indochina) (19). Although Taiwan is very close geographically to this area, no case of melioidosis has been reported. The present report describes the first imported case ofP. pseudomallei infection in Taiwan. Interestingly, the route of infection was neither airborne transmission nor introduction of the bacterium into a skin wound as reported for the majority of the cases (2, 7, 12). The patient acquired the organisms by aspiration of river water, and developed sepsis after a drowning incident near

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Section: Onpgmentioning

confidence: 56%

Section: Case Reportmentioning

confidence: 99%

Pseudomonas pseudomallei infection from drowning: the first reported case in Taiwan

Liao¹,

Wu²,

Lee³

et al. 1985

J Clin Microbiol

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“…On examination she was febrile with a temperature of 39.4"C; a full blood count demonstrated a pancytopenia with a white cell count of 3.0 X IOy/L and an erythrocyte sedimentation rate (ESR) of 18 revealed a right psoas abscess and blood cultures grew B. pseudomullei.…”

Section: Casementioning

confidence: 99%

Melioidotic Osteomyelitis in Northern Australia

Popoff

Nagamori

Currie

1997

Australian and New Zealand Journal of Surgery

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Background: Osteomyelitis is a well‐recognized manifestation of melioidosis, a significant disease that is endemic in South‐East Asia and northern Australia. Diagnosis requires a high degree of clinical suspicion and is dependent on microbiological confirmation; important clues are travel to or residence in an endemic area. Infection often but not always occurs in well‐recognized risk groups, especially diabetics and alcoholics. Subacute presentations often mimic other disease processes and patients may not always be clinically septic. Treatment requires surgical drainage in combination with multiple antibiotic therapy, including at least 2 weeks of intravenous ceftazidime and oral therapy continuing for 3–6 months. Non‐compliance usually results in relapse. Due to the potential long latency of the disease and the possibility of reactivation, follow‐up should probably be life‐long. Methods: A prospective study of 115 patients presenting with melioidosis between 1989 and 1995 was undertaken. Results: Four patients were found to have osteomyelitis. Conclusion: It is important to be aware of this condition so that early treatment can be initiated.

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