1887

Abstract

Introduction:

Melioidosis, a potentially life-threatening disease caused by , is common in Northern Australia and south-east Asia, but it is rarely encountered in the western world. However, due to increased travel, imported cases have been observed among tourists to endemic areas. The clinical manifestations are highly variable.

Case presentation:

We report a case of melioidosis presenting as pyelonephritis/urosepsis in a previously healthy German tourist who had travelled to several endemic regions.

Conclusion:

The described case highlights the fact that the diagnosis of melioidosis may be surprising to a routine diagnostic laboratory. An accidental and unwitting exposure of laboratory staff may occur before a definite identification is achieved. Good communication between the clinician and laboratory staff is crucial, especially with respect to travel histories.

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2015-10-09
2024-03-28
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References

  1. Abbink F. C., Orendi J. M., de Beaufort A. J. 2001; Mother-to-child transmission of Burkholderia pseudomallei . N Engl J Med 344:1171–1172 [View Article][PubMed]
    [Google Scholar]
  2. Anuntagool N., Sirisinha S. 2002; Antigenic relatedness between Burkholderia pseudomallei Burkholderia mallei . Microbiol Immunol 46:143–150 [View Article][PubMed]
    [Google Scholar]
  3. Ashdown L. R., Johnson R. W., Koehler J. M., Cooney C. A. 1989; Enzyme-linked immunosorbent assay for the diagnosis of clinical and subclinical melioidosis. J Infect Dis 160:253–260 [View Article][PubMed]
    [Google Scholar]
  4. Cheng A. C., Currie B. J. 2005; Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 18:383–416 [View Article][PubMed]
    [Google Scholar]
  5. Cheng A. C., O'Brien M., Freeman K., Lum G., Currie B. J. 2006; Indirect hemagglutination assay in patients with melioidosis in northern Australia. Am J Trop Med Hyg 74:330–334[PubMed]
    [Google Scholar]
  6. Cuadros J., Gil H., Miguel J. D., Marabé G., Gómez-Herruz T. A., Lobo B., Marcos R., Anda P. 2011; Case report: melioidosis imported from West Africa to Europe. Am J Trop Med Hyg 85:282–284 [View Article][PubMed]
    [Google Scholar]
  7. Currie B. J., Fisher D. A., Howard D. M., Burrow J. N., Lo D., Selva-Nayagam S., Anstey N. M., Huffam S. E., Snelling P. L., other authors. 2000; Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 31:981–986 [View Article][PubMed]
    [Google Scholar]
  8. Currie B. J., Jacups S. P., Cheng A. C., Fisher D. A., Anstey N. M., Huffam S. E., Krause V. L. 2004; Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia. Trop Med Int Health 9:1167–1174 [View Article][PubMed]
    [Google Scholar]
  9. Dance D. A., Wuthiekanun V., Naigowit P., White N. J. 1989; Identification of Pseudomonas pseudomallei in clinical practice: use of simple screening tests and API 20NE. J Clin Pathol 42:645–648 [View Article][PubMed]
    [Google Scholar]
  10. Dance D. A., Smith M. D., Aucken H. M., Pitt T. L. 1999; Imported melioidosis in England and Wales. Lancet 353:208 [View Article][PubMed]
    [Google Scholar]
  11. Frangoulidis D., Schwab D., Scholz H., Tomaso H., Hogardt M., Meyer H., Splettstoesser W. D., Pohle F. K. 2008; ‘Imported’ melioidosis in Germany: relapse after 10 years. Trans R Soc Trop Med Hyg 102:Suppl. 1S40–S41 [View Article][PubMed]
    [Google Scholar]
  12. Gee J. E., Sacchi C. T., Glass M. B., De B. K., Weyant R. S., Levett P. N., Whitney A. M., Hoffmaster A. R., Popovic T. 2003; Use of 16S rRNA gene sequencing for rapid identification and differentiation of Burkholderia pseudomallei B. mallei . J Clin Microbiol 41:4647–4654 [View Article][PubMed]
    [Google Scholar]
  13. Gétaz L., Abbas M., Loutan L., Schrenzel J., Iten A., Simon F., Decosterd A., Studer R., Sudre P., other authors. 2011; Fatal acute melioidosis in a tourist returning from Martinique Island, November 2010. Euro Surveill 16:19758[PubMed]
    [Google Scholar]
  14. Gilmore G., Barnes J., Ketheesan N., Norton R. 2007; Use of antigens derived from Burkholderia pseudomallei, B. thailandensis, and B. cepacia in the indirect hemagglutination assay for melioidosis. Clin Vaccine Immunol 14:1529–1531 [View Article][PubMed]
    [Google Scholar]
  15. Göbels K., Teichmann D., Richter J., Zysk G., Häussinger D. 2005; Diagnose: Melioidose. Dtsch Arztebl 102:2166–2169
    [Google Scholar]
  16. Godfrey A. J., Wong S., Dance D. A., Chaowagul W., Bryan L. E. 1991; Pseudomonas pseudomallei resistance to beta-lactam antibiotics due to alterations in the chromosomally encoded β-lactamase. Antimicrob Agents Chemother 35:1635–1640 [View Article][PubMed]
    [Google Scholar]
  17. Green R. N., Tuffnell P. G. 1968; Laboratory acquired melioidosis. Am J Med 44:599–605 [View Article][PubMed]
    [Google Scholar]
  18. Howe C., Sampath A., Spotnitz M. 1971; The pseudomallei group: a review. J Infect Dis 124:598–606 [View Article][PubMed]
    [Google Scholar]
  19. Inglis T. J., Chiang D., Lee G. S., Chor-Kiang L. 1998; Potential misidentification of Burkholderia pseudomallei by API 20NE. Pathology 30:62–64 [View Article][PubMed]
    [Google Scholar]
  20. Khupulsup K., Petchclai B. 1986; Application of indirect hemagglutination test and indirect fluorescent antibody test for IgM antibody for diagnosis of melioidosis in Thailand. Am J Trop Med Hyg 35:366–369[PubMed]
    [Google Scholar]
  21. Lowe P., Engler C., Norton R. 2002; Comparison of automated and nonautomated systems for identification of Burkholderia pseudomallei . J Clin Microbiol 40:4625–4627 [View Article][PubMed]
    [Google Scholar]
  22. Lumbiganon P., Pengsaa K., Puapermpoonsiri S., Puapairoj A. 1988; Neonatal melioidosis: a report of 5 cases. Pediatr Infect Dis J 7:634–636 [View Article][PubMed]
    [Google Scholar]
  23. McCormick J. B., Sexton D. J., McMurray J. G., Carey E., Hayes P., Feldman R. A. 1975; Human-to-human transmission of Pseudomonas pseudomallei . Ann Intern Med 83:512–513 [View Article][PubMed]
    [Google Scholar]
  24. Meumann E. M., Novak R. T., Gal D., Kaestli M. E., Mayo M., Hanson J. P., Spencer E., Glass M. B., Gee J. E., other authors. 2006; Clinical evaluation of a type III secretion system real-time PCR assay for diagnosing melioidosis. J Clin Microbiol 44:3028–3030 [View Article][PubMed]
    [Google Scholar]
  25. Novak R. T., Glass M. B., Gee J. E., Gal D., Mayo M. J., Currie B. J., Wilkins P. P. 2006; Development and evaluation of a real-time PCR assay targeting the type III secretion system of Burkholderia pseudomallei . J Clin Microbiol 44:85–90 [View Article][PubMed]
    [Google Scholar]
  26. Peacock S. J., Schweizer H. P., Dance D. A., Smith T. L., Gee J. E., Wuthiekanun V., DeShazer D., Steinmetz I., Tan P., Currie B. J. 2008; Management of accidental laboratory exposure to Burkholderia pseudomallei B. mallei . Emerg Infect Dis 14:e2 [View Article][PubMed]
    [Google Scholar]
  27. Schlech W. F. III, Turchik J. B., Westlake R. E. Jr, Klein G. C., Band J. D., Weaver R. E. 1981; Laboratory-acquired infection with Pseudomonas pseudomallei (melioidosis). N Engl J Med 305:1133–1135 [View Article][PubMed]
    [Google Scholar]
  28. Schmoock G., Ehricht R., Melzer F., Rassbach A., Scholz H. C., Neubauer H., Sachse K., Mota R. A., Saqib M., Elschner M. 2009; DNA microarray-based detection and identification of Burkholderia mallei, Burkholderia pseudomallei and Burkholderia spp. Mol Cell Probes 23:178–187 [View Article][PubMed]
    [Google Scholar]
  29. Schweizer H. P. 2012; When it comes to drug discovery not all Gram-negative bacterial biodefence pathogens are created equal: Burkholderia pseudomallei is different. Microb Biotechnol 5:581–583 [View Article][PubMed]
    [Google Scholar]
  30. Smith-Vaughan H. C., Gal D., Lawrie P. M., Winstanley C., Sriprakash K. S., Currie B. J. 2003; Ubiquity of putative type III secretion genes among clinical and environmental Burkholderia pseudomallei isolates in Northern Australia. J Clin Microbiol 41:883–885 [View Article][PubMed]
    [Google Scholar]
  31. Suputtamongkol Y., Hall A. J., Dance D. A., Chaowagul W., Rajchanuvong A., Smith M. D., White N. J. 1994; The epidemiology of melioidosis in Ubon Ratchatani, northeast Thailand. Int J Epidemiol 23:1082–1090 [View Article][PubMed]
    [Google Scholar]
  32. Suputtamongkol Y., Chaowagul W., Chetchotisakd P., Lertpatanasuwun N., Intaranongpai S., Ruchutrakool T., Budhsarawong D., Mootsikapun P., Wuthiekanun V., other authors. 1999; Risk factors for melioidosis and bacteremic melioidosis. Clin Infect Dis 29:408–413 [View Article][PubMed]
    [Google Scholar]
  33. Thibault F. M., Valade E., Vidal D. R. 2004; Identification and discrimination of Burkholderia pseudomallei, B. mallei, and B. thailandensis by real-time PCR targeting type III secretion system genes. J Clin Microbiol 42:5871–5874 [View Article][PubMed]
    [Google Scholar]
  34. Tomaso H., Scholz H. C., Al Dahouk S., Pitt T. L., Treu T. M., Neubauer H. 2004; Development of 5′ nuclease real-time PCR assays for the rapid identification of the Burkholderia mallei//Burkholderia pseudomallei complex. Diagn Mol Pathol 13:247–253 [View Article][PubMed]
    [Google Scholar]
  35. White N. J. 2003; Melioidosis. Lancet 361:1715–1722 [View Article][PubMed]
    [Google Scholar]
  36. Ziesché K., Reissbrodt R., Rische H. 1985; [A bile-chrysoidine-glycerol culture medium and its use in the diagnosis of Gram-negative aerobic bacteria, especially Enterobacteriaceae]. Z Gesamte Hyg 31:516–518[PubMed]
    [Google Scholar]
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