Mycotic aneurysm caused by burkholderia pseudomallei with negative blood cultures

Tanyaowalak, Wiriya; Sunthornyothin, Sarat; Luengtaviboon, Kittichai; Suankratay, Chusana; Kulwichit, Wanla

doi:10.1080/00365540310017465

Cited by 13 publications

(7 citation statements)

References 5 publications

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“… RTI: Respiratory tract infections; CT: computed tomography; TMP-SMZ: trimethoprim/sulfamethoxazole; AMC: amoxicillin/clavulanate; Blank cell: data not available; Grey cell: no; other colored cells: yes. Cases, including Case 1 [ 21 ], Case 2–3 [ 4 ], Case 4 [ 1 ],Case 5 [ 20 ],Case 6 [ 22 ],Case 7 [ 48 ],Case 8 [ 9 ], Case 9–10 [ 23 ], Case 11 [ 24 ], Case 12–14 [ 25 ], Case 15 [ 26 ], Case 16 [ 3 ], Case 17 [ 27 ], Case 18 [ 28 ], Case 19 [ 29 ], Case 20 [ 30 ], Case 21 [ 31 ], Case 22 [ 19 ], Case 23–24 [ 6 ], and Case 25–26 [ 10 ], Case 27 [ 52 ], Case 28 [ 18 ], Case 29 [ 32 ], Case 30 [ 33 ], Case 31 [ 41 ], Case 32 [ 35 ], Case 33 [ 36 ], Case 34 [ 8 ] Case 35 [ 37 ], Case36 [ 38 ], Case37 [ 39 ], and Case38 [ 40 ]. …”

Section: Resultsmentioning

confidence: 99%

“…It is documented that most patients with infected mycotic aneurysm secondary to melioidosis are male and aged 60 years [1,2,12,19]. Similarly, in our case series, the ages of eight subjects ranged from 48 to 69, with a median age of 61.5 years, all were indigenous males, and two [24], Case 12-14 [25], Case 15 [26], Case 16 [3], Case 17 [27], Case 18 [28], Case 19 [29], Case 20 [30], Case 21 [31], Case 22 [19], Case 23-24 [6], and Case 25-26 [10], Case 27 [52], Case 28 [18], Case 29 [32], Case 30 [33], Case 31 [41], Case 32 [35], Case 33 [36], Case 34 [8] Case 35 [37], Case36 [38], Case37 [39], and Case38 [40].…”

Section: Discussionmentioning

confidence: 99%

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Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Wang

Zhou

et al. 2020

PLoS Negl Trop Dis

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Burkholderia pseudomallei is the causative agent of melioidosis, endemic in Southeast Asia and Northern Australia, and increasingly recognized in southern China, especially in Hainan Province. Mycotic aneurysm caused by B. pseudomallei is a rare but potentially severe illness with a high mortality rate. The clinical features of the mycotic aneurysm secondary to melioidosis have not been illustrated in China. Over a seven-year period (2013 to 2019), 159 patients with bacteremic melioidosis were retrospectively analyzed in Hainan province, China, of whom eight patients were confirmed to have mycotic aneurysm through the combination of imaging examination, pathologic examination and aneurysm tissue culture. We summarized these eight patients' clinical characteristics, demographical features, treatments and outcomes. The susceptibilities to five commonly-used antibiotics for these eight B. pseudomallei isolates were also determined by E-test strips. Furthermore, the mycotic aneurysm cases secondary to melioidosis retrieved from the literature were also reviewed. Of the eight cases, six had abdominal mycotic aneurysms, one had a left iliac aneurysm, and the other one had an infectious mesenteric aneurysm. They were aged from 48 to 69 years old, and had the underlying risk factors of diabetes mellitus (2 patients), long-term smoking (4 patients), hypertension (6 patients), and soil and water contact history (6 patients), respectively. The positive arterial aneurysm imaging was observed in all patients via computed tomography (CT) or angiography. Eight B. pseudomallei isolates collected from both blood and mycotic aneurysm tissues remained 100% susceptible to imipenem and ceftazidime. After surgery combined with antibiotic administration, six patients survived, with a mortality rate of 25%. In melioidosis endemic areas, the mycotic aneurysm secondary to melioidosis might be underdiagnosed, and increased awareness of predisposing risk factors and clinical features of the mycotic aneurysm is required. Following a positive B. pseudomallei blood culture, the diagnosis of mycotic aneurysm should be under consideration in PLOS NEGLECTED TROPICAL DISEASES

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Wang

Zhou

et al. 2020

PLoS Negl Trop Dis

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“…In that study, about 80% of patients had risk factors including diabetes mellitus (39%), alcohol abuse (39%), chronic lung disease (26%), chronic renal disease (12%), rheumatic heart disease and/or congestive heart failure (7%), malignancies (6%), and immunosuppression (6%) [ 4 ]. In another study of infected aortic aneurysms in an endemic area for melioidosis, the most common comorbidities identified were hypertension and renal disease with some degree of atherosclerosis also playing a role [ 5 ]. In accordance with these studies, our patient was hypertensive and also had atherosclerotic changes in aortogram.…”

Section: Discussionmentioning

confidence: 99%

Burkholderia Aortic Aneurysm: A Case Report and Review of the Literature

Panginikkod

Ramachandran

Bollimunta

et al. 2017

Case Reports in Infectious Diseases

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Melioidosis is a frequently fatal infection caused by the Gram-negative bacillus Burkholderia pseudomallei endemic to Southeast Asia and Northern Australia. It is a rare imported pathogen in the United States and is a potential bioterror agent. We report the case of an 82-year-old previously healthy man who presented with 2 weeks of fever and epigastric pain after he returned from the Philippines. A diagnosis of nondissecting mycotic aneurysm in the descending thoracic aorta was made with the help of CT angiogram and positive blood cultures. The patient completely recovered with a 6-month antibiotic therapy followed by surgical repair of the aneurysm. Given the slight increase in the number of melioidosis cases reported by CDC since 2008, melioidosis might be considered an emerging infectious disease in the United States. The purpose of this report is to raise awareness of the disease among clinicians as well as travelers.

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“…To the best of our knowledge, only very few reports exist of mycotic aneurysms by B. pseudomallei in returning travellers without any established risk factors,14 15 but mycotic aneurysms have been described in travellers with risk factors16 and in endemic areas such as Australia,12 Southeast Asia4 8 17 and Brazil 7…”

Section: Discussionmentioning

confidence: 99%

Mycotic aneurysm caused byBurkholderia pseudomalleiin a previously healthy returning traveller

et al. 2014

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Burkholderia pseudomalleiis a common cause of serious, difficult to treat infections in South-East Asia and Northern Australia, but is a rare imported pathogen in the USA and Europe. We report a case of a patient with a mycotic aneurysm caused byB. pseudomalleiin a previously healthy returning traveller. The patient presented with 4 weeks of abdominal pain and intermittent fever after a brief vacation in Thailand. The aneurysm was excised and replaced by an autologous deep vein graft, and the patient was treated for 6 months with antibiotics adjusted according to postoperative renal impairment. Twenty-four months after surgery the patient is well and without relapse.

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Mycotic aneurysm caused by burkholderia pseudomallei with negative blood cultures

Cited by 13 publications

References 5 publications

Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Burkholderia Aortic Aneurysm: A Case Report and Review of the Literature

Mycotic aneurysm caused byBurkholderia pseudomalleiin a previously healthy returning traveller

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