title: Changing epidemiology of melioidosis? A case of acute pulmonary melioidosis with fatal outcome imported from Brazil.
abstract: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is endemic in South East Asia and tropical regions of Northern Australia. Sporadic cases have been described elsewhere. In this article we present a case of acute pulmonary melioidosis with fatal outcome imported from Brazil. The most common pathogen causing severe community-acquired pneumonia in Brazil is Streptococcus pneumoniae. Other possible pathogens include Legionella spp., Mycoplasma pneumonia, Gram-negative rods and viruses. There are few reports of melioidosis in the Americas. This article represents the second known human case of melioidosis from Brazil. Recognition of melioidosis as a possible cause of severe pneumonia, even if a patient has not been travelling in a highly endemic area, is important because of the therapeutic consequences. The epidemiology of melioidosis will be reviewed.
authors.affiliation: Department of Internal Medicine, Bronovo Hospital, The Hague, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Aardema
authors.forename: E M
authors.initials: EM
authors.lastname: Luijnenburg
authors.forename: E F
authors.initials: EF
authors.lastname: Salm
authors.forename: H A
authors.initials: HA
authors.lastname: Bijlmer
authors.forename: C E
authors.initials: CE
authors.lastname: Visser
authors.forename: J W
authors.initials: JW
authors.lastname: Van't Wout
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001938:Brazil / Q000453:epidemiology; D016957:Burkholderia pseudomallei / Q000302:isolation & purification*; D003922:Diabetes Mellitus, Type 1; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008554:Melioidosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D009426:Netherlands; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D011859:Radiography; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents