title: Melioidosis as a travel-associated infection: Case report and review of the literature.
abstract: BACKGROUND
  Increasing numbers of sporadic cases of melioidosis in returning travelers have been reported from non-endemic regions.
  
  
  METHODS
  We report a new case and undertook a literature review.
  
  
  RESULTS
  Eighty-two travelers with melioidosis infection were included. The mean age was 50.95 years, with only one case <15 years. A male predominance was noted, with 66 males (80.5%). Type of travel included tourism (51.2%), family visits (15.8%) and business (14.6%). The most common destinations were Asia (80.5%), America (9.7%) and Africa (7.3%). No cases were documented from Oceania. Underlying conditions were documented in 68 patients, showing a strong association with diabetes (37.8%). Exposure risks were documented in 32 patients, including contact with water. Pulmonary involvement was seen in 41 patients, cutaneous in 23, abdominal in 14, and urogenital in 10 cases. Blood cultures posed the diagnosis in 43 cases. Fifty-seven patients fully recovered, 12 died, and three relapsed. The mortality rate (14.6%) was close to that observed in Australia but lower than series in Southern Asia.
  
  
  CONCLUSIONS
  Melioidosis should not only be considered in travelers returning from classically considered endemic areas (Australia and South-East Asia) but also from America and Africa, especially in diabetic patients or after contact with water.
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Service de Maladies Infectieuses et Tropicales, Pôle Maladies Infectieuses, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Saïdani
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Service de Maladies Infectieuses et Tropicales, Pôle Maladies Infectieuses, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France.
authors.forename: Karolina
authors.initials: K
authors.lastname: Griffiths
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Service de Maladies Infectieuses et Tropicales, Pôle Maladies Infectieuses, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, 13005 Marseille, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Million
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Service de Maladies Infectieuses et Tropicales, Pôle Maladies Infectieuses, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, 13005 Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, 13005 Marseille, France; Assistance Publique Hôpitaux de Marseille, CHU Timone, Pôle Maladies Infectieuses, Fédération de Microbiologie, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dubourg
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, 13005 Marseille, France; Assistance Publique Hôpitaux de Marseille, CHU Timone, Pôle Maladies Infectieuses, Service de Maladies Infectieuses Aigues, Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Service de Maladies Infectieuses et Tropicales, Pôle Maladies Infectieuses, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, 13005 Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, 13005 Marseille, France; Assistance Publique Hôpitaux de Marseille, CHU Timone, Pôle Maladies Infectieuses, Service de Maladies Infectieuses Aigues, Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France. Electronic address: jean-christophe.lagier@ap-hm.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lagier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008554:Melioidosis; D008875:Middle Aged
keywords: Burkholderia pseudomallei; Melioidosis; Splenic vein thrombosis; Travel-associated infection