Pleuropulmonary melioidosis in a Cambodian refugee

A 47-year-old Cambodian refugee presented with an acute respiratory illness that featured consolidation of the lower lobe of the left lung and progressive involvement of the adjacent pleura caused by Pseudomonas pseudomallei. Initial difficulty in identifying the organism resulted in an inadequate duration of therapy. Chronic pleural disease followed, and the organism became resistant to many antibiotics during therapy. A diagnosis of pleuropulmonary melioidosis should be entertained and the microbiology laboratory alerted when patients with pneumonia who are from endemic areas are encountered, so that a diagnosis can be made early and the appropriate treatment begun.