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Melioidosis Aortic Aneurysms, 2019-2025: Incidence, Management and Outcomes From a Regional Tertiary Centre in North

Oh Sung Choy1,2, David Sun1,2, Vimalin Vedanayagam1

  • 1Department of Vascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia.

ANZ Journal of Surgery
|November 28, 2025
PubMed
Abstract

Insights

Melioidosis-associated aortic aneurysms are rare but dangerous surgical emergencies in endemic areas. Prompt diagnosis and treatment are crucial for improving patient outcomes and reducing high mortality risks.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is an uncommon but severe cause of mycotic aortic aneurysms.
  • Endemic regions include North Queensland and Southeast Asia, posing significant health risks.

Purpose of the Study:

  • To describe the presentation, management, and outcomes of melioidosis-associated aortic aneurysms.
  • To evaluate the effectiveness of current treatment strategies in a regional tertiary center.

Main Methods:

  • Retrospective review of aortic aneurysm repairs (open and endovascular) from January 2019 to May 2025.
  • Collection of patient demographics, comorbidities, aneurysm characteristics, procedural details, and short-term/long-term outcomes.

Main Results:

  • Six out of 217 aortic aneurysm repairs (2.8%) were mycotic, with five yielding B. pseudomallei.
  • Four patients presented with emergency ruptures; aneurysm diameters ranged from 30-60mm.
  • Mortality rate was 40% (2/5 patients), with one early death and one late death from unrelated causes.

Conclusions:

  • Melioidosis aortic aneurysms in endemic regions typically present as surgical emergencies with high mortality.
  • Prompt imaging, microbiological diagnosis, and rapid surgical repair with antimicrobial therapy are essential.
  • Multicenter studies are needed to optimize long-term management and antibiotic protocols.
Keywords:
Burkholderia pseudomalleiabdominal aortic aneurysmsendemicendovascular aneurysm repair (EVAR)mycotic aneurysmsruptured aneurysmsvascular surgery

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