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Melioidosis and bilateral third-nerve palsies.
Neurology
|January 1, 1984
Summary
Melioidosis affecting the central nervous system is rare. A case of Pseudomonas pseudomallei meningitis, diagnosed 13 years after exposure, highlights the possibility of long latent periods for this infection.
Area of Science:
- Infectious Diseases
- Neurology
- Tropical Medicine
Background:
- Melioidosis, caused by Pseudomonas pseudomallei, is endemic in Southeast Asia.
- Central nervous system (CNS) involvement in melioidosis is uncommon, with meningitis being a rare manifestation.
Observation:
- A 34-year-old man presented with bilateral third-nerve palsies, indicative of CNS involvement.
- The patient had a history of exposure to Southeast Asia 13 years prior to symptom onset.
Findings:
- Diagnosis of Pseudomonas pseudomallei meningitis was confirmed by a fourfold increase in serum antibody titers.
- Successful treatment involved a combination of rifampin, isoniazid hydrochloride, ethambutol, and trimethoprim-sulfamethoxazole.
Implications:
- The case underscores the potential for long latent periods in melioidosis, with infections manifesting years after initial exposure.
- Increased vigilance is warranted for melioidosis in individuals with a history of travel to endemic areas, particularly veterans.