Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

Area of Science:

• Infectious Diseases
• Microbiology
• Vascular Surgery

Background:

• Melioidosis is a complex infectious disease endemic in Southeast Asia and Northern Australia, caused by Burkholderia pseudomallei.
• Early diagnosis and appropriate treatment are crucial for managing melioidosis, which presents with diverse clinical manifestations.

Observation:

• A case report of an immunocompetent man who developed an infected aortic aneurysm due to Burkholderia pseudomallei six months after traveling to Northern Malaysia.
• The patient initially received inadequate surgical and antibiotic interventions, resulting in a peri-prosthetic aortic infection, lumbar spondylitis, and a psoas muscle abscess.

Findings:

• Burkholderia pseudomallei can cause severe vascular infections, such as infected aortic aneurysms, even in immunocompetent individuals.
• Diagnosis of melioidosis can be challenging due to its varied presentations and limitations of standard microbiological identification methods for B. pseudomallei.

Implications:

• Melioidosis should be considered in the differential diagnosis of unexplained fevers in patients with a travel history to endemic regions.
• This case underscores the importance of considering melioidosis in complex infections involving vascular structures and adjacent tissues, particularly after travel to endemic areas.
• Improved diagnostic strategies and awareness are needed to effectively manage melioidosis and prevent severe outcomes.