关键词: Burkholderia pseudomallei diabetes mellitus melioidosis pleural effusion systemic infection

Mesh : Abscess / pathology Acute Disease Anti-Bacterial Agents / pharmacology therapeutic use Burkholderia pseudomallei / drug effects isolation & purification Diabetes Complications Diagnosis, Differential Diagnostic Errors Fever / etiology Humans India Male Melioidosis / complications diagnosis microbiology physiopathology Microbial Sensitivity Tests Middle Aged Pleural Effusion / diagnostic imaging Pneumonia / etiology Pseudomonas Infections / diagnosis microbiology Skin / pathology Tomography, X-Ray Computed

来  源:   DOI:10.5603/PiAP.2016.0012

Abstract:
Melioidosis, caused by the environmental saprophyte, Burkholderia pseudomallei, is an important public health problem in Southeast Asia and Northern Australia. It is being increasingly reported from other parts, including India, China, and North and South America expanding the endemic zone of the disease. We report a case of systemic melioidosis in a 58-year-old diabetic, occupationally-unexposed male patient, who presented with chronic fever, sepsis, pneumonia, pleural effusion and subcutaneous abscess, was undiagnosed for long, misidentified as Pseudomonas aeruginosa infection elsewhere, but was saved due to correct identification of the etiologic agent and timely institution of appropriate therapy at our institute. A strong clinical and microbiological suspicion for melioidosis should be considered in the differential diagnosis of acute pyrexia of unknown origin, acute respiratory distress syndrome and acute onset of sepsis, especially in the tropics.
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