title: Melioidosis and the vacuum-assisted closure device: a rare cause of a discharging neck wound, and a new approach to management.
abstract: OBJECTIVE
  We report a case of melioidosis presenting as a discharging neck abscess, and we describe the use of a vacuum-assisted closure device in its management.
  
  
  METHODS
  We report the case of a 44-year-old, Afro-Caribbean woman with melioidosis. We also present the results of a literature search using the search terms 'melioidosis', 'Burkholderia pseudomallei' and 'vacuum-assisted closure device'.
  
  
  RESULTS
  Microbiological analysis identified the causative organism as being the bacterium Burkholderia pseudomallei, and its antimicrobial sensitivities to imipenem and ciprofloxacin. A vacuum-assisted closure device was used to manage the patient's melioidosis of the neck; we believe this is the first report of such treatment.
  
  
  CONCLUSIONS
  Melioidosis is rare in the UK and western world; however, exposure can occur during travel to endemic areas. We therefore draw attention to this infection as part of the differential diagnosis of a neck abscess. We propose the use of vacuum-assisted closure devices as useful adjuncts to the management of discharging neck wounds.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK. garas_george@yahoo.com
authors.forename: G
authors.initials: G
authors.lastname: Garas
authors.forename: S
authors.initials: S
authors.lastname: Ifeacho
authors.forename: R
authors.initials: R
authors.lastname: Millard
authors.forename: N
authors.initials: N
authors.lastname: Tolley
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000628:therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016957:Burkholderia pseudomallei / Q000302:isolation & purification; D002939:Ciprofloxacin / Q000627:therapeutic use; D004322:Drainage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007828:Laryngoscopy / Q000379:methods; D008554:Melioidosis / Q000150:complications / Q000628:therapy*; D009333:Neck; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000628:therapy; D014945:Wound Healing / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin