title: Disseminated melioidosis in the head and neck.
abstract: A 35-year-old man was admitted to an intensive care unit with unilateral facial swelling and septic shock after multiple presentations to the emergency department with non-specific unilateral pain over the parotid area. A CT scan of his neck showed diffuse right-sided facial soft tissue infection, mastoid effusion and temporal lobe cerebritis. The upper lobes of his lungs had cannonball lesions that were suggestive of septic lung metastases. Blood cultures and ear canal swabs were positive for Burkholderia pseudomallei The temporal lobe cerebritis eventually developed into an abscess, necessitating a cortical mastoidectomy, craniectomy and temporal lobectomy. After the surgical interventions, antibiotic therapy was continued for a further 6 months. The patient remained well and had no signs of recurrence up to 7 months after the initial presentation.
authors.affiliation: Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
authors.forename: Tze Ling
authors.initials: TL
authors.lastname: Loh
authors.affiliation: Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
authors.forename: Sergios
authors.initials: S
authors.lastname: Latis
authors.affiliation: Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Crossland
authors.affiliation: Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
authors.forename: Hemi
authors.initials: H
authors.lastname: Patel
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D016957:Burkholderia pseudomallei; D006801:Humans; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging* / Q000601:surgery; D008417:Mastoiditis / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D008554:Melioidosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D019635:Neurosurgical Procedures; D018410:Pneumonia, Bacterial / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D012772:Shock, Septic / Q000209:etiology; D018461:Soft Tissue Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents