期刊
BMJ CASE REPORTS
卷 14, 期 6, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2020-241490
关键词
dermatology; infections; tropical medicine (infectious disease); wound care
The case illustrates the importance of maintaining a high level of clinical suspicion and close microbiological liaison in individuals returning from South-East Asia and northern Australia with symptoms indicative of cutaneous melioidosis. This is crucial as many clinical microbiology laboratories may have limited diagnostics for security-related organisms, potentially leading to misidentification of the causative bacterium Burkholderia pseudomallei.
A 26-year-old man, returned to the UK having travelled extensively in Asia. He was referred with a 3-month history of distal leg ulceration following an insect bite while in Thailand. Despite multiple courses of oral antibiotics, he developed two adjacent ulcers. A wound swab isolated an organism identified as Burkholderia thailandensis. The histology of the skin biopsy was non-specific. A diagnosis of cutaneous melioidosis was made, based on clinical and microbiological grounds. The ulcers re-epithelialised on completion of intravenous ceftazidime followed by 3 months of high dose co-trimoxazole and wound care. Many clinical microbiology laboratories have limited diagnostics for security-related organisms, with the result that B. pseudomallei, the causative bacterium of melioidosis, may be misidentified. This case highlights the importance of maintaining high levels of clinical suspicion and close microbiological liaison in individuals returning from South-East Asia and northern Australia with such symptoms.
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