Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

BMJ Case Rep. 2019 May 22;12(5):e228856. doi: 10.1136/bcr-2018-228856.

Abstract

Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.

Keywords: bone and joint infections; cardiovascular system; infections; tropical medicine (infectious disease); urinary tract infections.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Infected / complications
  • Aneurysm, Infected / diagnosis*
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / microbiology
  • Anti-Bacterial Agents / therapeutic use
  • Burkholderia pseudomallei / isolation & purification*
  • Diagnosis, Differential
  • Humans
  • Malaysia
  • Male
  • Melioidosis / complications
  • Melioidosis / diagnosis*
  • Melioidosis / diagnostic imaging
  • Melioidosis / microbiology
  • Middle Aged
  • Pyelonephritis / complications
  • Pyelonephritis / diagnosis*
  • Pyelonephritis / diagnostic imaging
  • Pyelonephritis / microbiology
  • Renal Artery*
  • Tomography, X-Ray Computed
  • Travel*

Substances

  • Anti-Bacterial Agents