Melioidosis: recrudescence with a strain resistant to multiple antimicrobials.
We describe a recent case of melioidosis presenting classically in a young Vietnam veteran. The case demonstrates extensive antibiotic resistance in this isolate and failure of ceftriaxone, despite its in vitro efficacy. Other multiple antimicrobial regimens also failed. Melioidosis remains a concern in patients who have previously lived in endemic areas. A high level of diagnostic suspicion is required, especially in patients with a febrile illness or tuberculosis-like presentations. Early detection of Pseudomonas pseudomallei and rational treatment of adequate duration are critical in successful management.
D000328:Adult; D004352:Drug Resistance, Microbial; D006801:Humans; D008171:Lung Diseases / Q000382:microbiology*; D008297:Male; D008554:Melioidosis / Q000382:microbiology*; D010019:Osteomyelitis / Q000382:microbiology; D011549:Pseudomonas / Q000187:drug effects*; D018805:Sepsis / Q000382:microbiology; D014728:Veterans; D014744:Vietnam