title: Successful treatment of life-threatening melioidosis with activated protein C and meropenem.
abstract: Melioidosis is an endemic disease in southeast Asia and northern Australia, caused by Burkholderia pseudomallei. A typhoon-related outbreak occurred in southern Taiwan in July 2005. High mortality in melioidosis associated with bacteremic pneumonia and septic shock. We report a patient with life-threatening melioidosis who developed rapid progression of bacteremic pneumonia with acute respiratory distress syndrome, septic shock and multiple organ dysfunction and was successfully treated with recombinant human activated protein C (rhAPC) and meropenem. Although rhAPC has been reported to reduce the mortality of severe septic shock caused by various pathogens, to our best knowledge, this is the first reported case of rhAPC application in life-threatening melioidosis.
authors.affiliation: Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Che Kim
authors.initials: CK
authors.lastname: Tan
authors.forename: Khee Siang
authors.initials: KS
authors.lastname: Chan
authors.forename: Wen Liang
authors.initials: WL
authors.lastname: Yu
authors.forename: Chin Ming
authors.initials: CM
authors.lastname: Chen
authors.forename: Kuo Chen
authors.initials: KC
authors.lastname: Cheng
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016957:Burkholderia pseudomallei; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008554:Melioidosis / Q000150:complications / Q000188:drug therapy*; D000077731:Meropenem; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D018410:Pneumonia, Bacterial / Q000209:etiology; D011486:Protein C / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012772:Shock, Septic / Q000209:etiology; D013845:Thienamycins / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; D013845:Thienamycins; D000077731:Meropenem