Melioidosis in a patient from Bangladesh.
A 54 year old Bangladeshi man presented with a history and chest X-ray appearances suggestive of pulmonary tuberculosis. Following deterioration 4 weeks later, he required ventilation. Although a blood culture isolate was subsequently found to be Pseudomonas pseudomallei, it was initially misidentified and dismissed as a contaminant. Further cultures demonstrated the organism, but the patient died, despite treatment with ceftazidime. The case illustrates the importance of taking a detailed travel history and having a high index of suspicion in patients from South East Asia and the Indian sub-continent, including Bangladesh, where the disease has not previously been considered endemic.
Kibbler
C C
CC
Department of Clinical Microbiology, University College Hospital, London, UK.
Roberts
C M
CM
Ridgway
G L
GL
Spiro
S G
SG
D001459:Bangladesh / Q000208:ethnology; D016957:Burkholderia pseudomallei / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008554:Melioidosis / Q000175:diagnosis*; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis; D006113:United Kingdom