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Fulminant septic melioidosis after a vacation in Thailand

A Schwarzmaier1, F Riezinger-Geppert, G Schober

  • 1Second Department of Medicine, KA Rudolfstiftung, Vienna, Austria.

Wiener Klinische Wochenschrift
|March 14, 2001
PubMed

Insights

Melioidosis, a severe bacterial infection caused by Burkholderia pseudomallei, is prevalent in Southeast Asia and Australia. A case highlights the high mortality risk, even with treatment, particularly in diabetic patients.

Area of Science:

  • Infectious Diseases
  • Tropical Medicine
  • Bacteriology

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is a significant cause of acquired septicemia in Southeast Asia and Northern Australia.
  • The disease presents a spectrum from asymptomatic infection to fulminant sepsis, with increased severity in immunocompromised individuals, renal failure, or diabetes mellitus.

Observation:

  • A 29-year-old male with Type I diabetes contracted melioidosis during travel in Thailand.
  • Upon returning to Austria, he developed multiple organ failure and required intensive care.

Findings:

  • Despite intensive care and appropriate antibiotic treatment (ceftazidime, co-trimoxazole, doxycycline), the patient's infection was lethal.
  • Burkholderia pseudomallei was successfully isolated from blood and bronchoalveolar lavage samples, confirming the diagnosis.

Implications:

  • This case underscores the critical threat of melioidosis, especially in travelers with predisposing conditions like diabetes.
  • Highlights the need for increased awareness and diagnostic vigilance for melioidosis in non-endemic regions.
  • Emphasizes the high mortality associated with severe melioidosis and the challenges in treatment, even with optimal medical care.

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