[An acute septic course of melioidosis after a stay in Thailand].
METHODS
Two weeks after returning from a trip to Thailand a 79-year-old man developed a higher fever, pain in the right flank and progressive clouding of consciousness. She had meningism on admission.


METHODS
There was a marked leukocytosis (WBC count 17,700/microliter) and raised C-reactive protein (6.5 mg/dl). Cerebrospinal fluid was clear, containing 119 cells/mm3 and elevated protein (90 mg/dl). Abdominal sonography demonstrated segmental pyelonephritis, and blood culture grew Pseudomonas pseudomallei.


METHODS
On the basis of sensitivity tests imipenem was chosen as the antibiotic and was given for 6 weeks. Because of an inadequate response and a right renal abscess a right nephrectomy was performed. After marked improvement the septicaemia recurred one week after antibiotic treatment had been discontinued, and the patient died.


CONCLUSIONS
Efficacious treatment of melioidosis (a glanders-like disease) presupposes diagnosis of the causative microorganism and testing of its antibiotic sensitivity. As Pseud. pseudomallei may encapsulate and persist intracellularly, the selection of antibiotic and the duration of treatment are crucial.
Koch
F W
FW
III. Innere Abteilung, Krankenhaus Neukölln, Berlin.
Zöller
M
M
Pankow
W
W
Kohl
F V
FV
Küchler
R
R
D000038:Abscess / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D000208:Acute Disease; D000368:Aged; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017809:Fatal Outcome; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008554:Melioidosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D009392:Nephrectomy; D013785:Thailand; D013845:Thienamycins / Q000008:administration & dosage; D014195:Travel
D013845:Thienamycins; D015378:Imipenem
Akute septische Verlaufsform einer Melioidose nach Thailandaufenthalt.