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.

Conclusion: 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.

Keywords: Burkholderia pseudomallei; Melioidosis; Splenic vein thrombosis; Travel-associated infection.