title: "Melioidosis in Antioquia, Colombia: an emerging or endemic disease? A cases series".
abstract: BACKGROUND
  Melioidosis is endemic in Malaysia, the southwest of Thailand, and northern Australia. The incidence in Thailand is 4.4/1000000 inhabitants, where it causes 19% of community-acquired pneumonia (CAP) and 20% of bacteremic pneumonia, and the mortality is 50%. Sporadic cases have been described in Central and South America. The objective of this study was to describe the clinical and epidemiological features and ecological characteristics of melioidosis in Antioquia, Colombia.
  
  
  METHODS
  This is a case series description.
  
  
  RESULTS
  Seven cases were identified. Burkholderia pseudomallei was isolated from peripheral blood, pleural fluid, and urine and was identified by the automated system VITEK 2 (bioMérieux) and API 20NE biochemical kit. Five of the cases had a bacteremic form with shock and pulmonary compromise and two of these patients died. The non-bacteremic melioidosis cases had genitourinary, abdominal, and osteoarticular compromise. All patients had comorbidities and lived in rural hot and humid areas in the west central region of Colombia (Antioquia). Diabetes mellitus, renal insufficiency, and other chronic diseases are important risk factors for the development of severe forms.
  
  
  CONCLUSIONS
  The cases presented here are similar to those occurring in endemic areas regarding comorbidity, risk factors, clinical presentation, and environmental conditions. It is necessary to establish whether melioidosis is an endemic and under-diagnosed disease or an emerging disease in Colombia.
authors.affiliation: Infectious Diseases Section, Pablo Tobón Uribe Hospital, Medellín, Colombia; Pulmonology Unit, León XIII Clinic of Antioquia University, Medellín, Colombia; Research Group in Respiratory and Infectious Diseases (GIERI), Medellín, Colombia. Electronic address: frmontufar@yahoo.com.
authors.forename: F E
authors.initials: FE
authors.lastname: Montúfar
authors.affiliation: Epidemiology Group, National School of Public Health, Antioquia University, Medellín, Colombia.
authors.forename: J E
authors.initials: JE
authors.lastname: Ochoa
authors.affiliation: Internal Medicine and Pulmonology, Antioquia University, Medellín, Colombia.
authors.forename: H
authors.initials: H
authors.lastname: Ortega
authors.affiliation: Cardiovascular Clinic, Medellín, Colombia.
authors.forename: L
authors.initials: L
authors.lastname: Franco
authors.affiliation: Faculty of Medicine, Pontificia Bolivariana University, Medellín, Colombia; Research Group in Respiratory and Infectious Diseases (GIERI), Medellín, Colombia.
authors.forename: M C
authors.initials: MC
authors.lastname: Montúfar
authors.affiliation: Faculty of Medicine, Pontificia Bolivariana University, Medellín, Colombia; Research Group in Respiratory and Infectious Diseases (GIERI), Medellín, Colombia.
authors.forename: A
authors.initials: A
authors.lastname: Monsalve
authors.affiliation: Faculty of Medicine, Pontificia Bolivariana University, Medellín, Colombia; Research Group in Respiratory and Infectious Diseases (GIERI), Medellín, Colombia.
authors.forename: C
authors.initials: C
authors.lastname: Jaramillo
authors.affiliation: Faculty of Medicine, Pontificia Bolivariana University, Medellín, Colombia; Research Group in Respiratory and Infectious Diseases (GIERI), Medellín, Colombia.
authors.forename: M
authors.initials: M
authors.lastname: Zapata
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology; D016957:Burkholderia pseudomallei / Q000302:isolation & purification*; D002648:Child; D003105:Colombia / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008554:Melioidosis / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D051437:Renal Insufficiency / Q000453:epidemiology; D012307:Risk Factors; D013020:South America
keywords: Burkholderia pseudomallei; Melioidosis; Pneumonia; Sepsis