Successful treatment of life-threatening melioidosis with activated protein C and meropenem.
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.
Tan
Che Kim
CK
Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
Chan
Khee Siang
KS
Yu
Wen Liang
WL
Chen
Chin Ming
CM
Cheng
Kuo Chen
KC
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*
D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; D013845:Thienamycins; D000077731:Meropenem