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Case report: recovery from persistent septicemic melioidosis
T J Inglis1, C L Golledge, A Clair
1Division of Microbiology and Infectious Diseases, Western Australian Centre for Pathology and Medical Research, Nedlands, Australia.
The American Journal of Tropical Medicine and Hygiene
|August 16, 2001
Summary
Septicemic melioidosis can be fatal, even with antibiotics like ceftazidime. Combination therapy with meropenem, ciprofloxacin, surgery, and supportive care improved survival in a persistent Burkholderia pseudomallei bacteremia case.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Septicemic melioidosis, caused by Burkholderia pseudomallei, has a high mortality rate.
- In vitro sensitivity to ceftazidime does not always ensure treatment success.
Observation:
- A patient presented with persistent Burkholderia pseudomallei bacteremia despite intravenous ceftazidime therapy.
- Intracellular minimum inhibitory concentration analysis guided antibiotic selection.
Findings:
- Combination therapy with meropenem and ciprofloxacin, alongside splenectomy and metabolic acidosis correction, led to patient discharge.
- Pulsed-field gel electrophoresis confirmed isolates matched those from a previous outbreak.
Implications:
- Combination antibiotic therapy with intracellular activity, surgery, and critical care may enhance survival in severe melioidosis.
- This case highlights the importance of tailored treatment strategies for persistent infections.