title: Colonization or spontaneous resolution: expanding the role for Burkholderia pseudomallei.
abstract: A 19-year-old Asian Indian female presented with productive cough since the past one month and low grade fever since the past two weeks. She was diagnosed with pulmonary tuberculosis and treated with antitubercular drugs. Subsequently, delayed cultures of bronchoalveolar lavage fluid grew Burkholderia pseudomallei (B. pseudomallei). On follow up the patient reported significant subjective improvement and ESR progressively returned to normal. In summary, this case report raises two distinct and equally intriguing roles for B. pseudomallei, i.e. respiratory colonization and spontaneously resolving pulmonary infection. The pathogenic potential of B. pseudomallei, the etiologic agent of melioidosis, is well known. Confirmation of either colonization or spontaneous resolution, would potentially spare many patients unnecessary and expensive therapy with broad-spectrum antibiotics, and contribute to more rational usage of antibiotics, especially in co-infection with Mycobacterium tuberculosis and B. pseudomallei-two bacterial diseases with closely similar clinical, radiologic and histopathologic features.
authors: Department of Medicine, Kasturba Hospital, Manipal-576 104, Karnataka, India.
authors: Kushal
authors: K
authors: Naha
authors: Department of Medicine, Kasturba Hospital, Manipal-576 104, Karnataka, India.
authors: Barkur Ananthakrishna
authors: BA
authors: Shastry
authors: Department of Medicine, Kasturba Hospital, Manipal-576 104, Karnataka, India.
authors: Kavitha
authors: K
authors: Saravu
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D016957:Burkholderia pseudomallei / Q000302:isolation & purification*; D060085:Coinfection; D005260:Female; D006801:Humans; D008554:Melioidosis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Burkholderia pseudomallei; Coinfection; Colonizer; Melioidosis; Spontaneous resolution; Tuberculosis