Melioidosis is an infectious disease caused by a gram-negative saprophyte bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It mostly infects adults with predisposing conditions, mainly diabetes mellitus. The lung is the most commonly affected organ. The spectrum of melioidois in human varies from subclinical to overwhelming protean manifestations resembling other acute and chronic bacterial infections. We report herein a case of septicemia and septic pneumonia due to Burkholderia pseudomallei in 47-year-old man with diabetes mellitus who has history of traveling to Malaysia. This is the first report of melioidosis in Korea.
Adult ; Asia, Southeastern ; Australia ; Bacterial Infections ; Burkholderia pseudomallei* ; Burkholderia* ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Korea ; Lung ; Malaysia ; Melioidosis ; Middle Aged ; Pneumonia* ; Sepsis*

Melioidosis is an infectious disease caused by a gram-negative saprophyte bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It mostly infects adults with predisposing conditions, mainly diabetes mellitus. The lung is the most commonly affected organ. The spectrum of melioidois in human varies from subclinical to overwhelming protean manifestations resembling other acute and chronic bacterial infections. We report herein a case of septicemia and septic pneumonia due to Burkholderia pseudomallei in 47-year-old man with diabetes mellitus who has history of traveling to Malaysia. This is the first report of melioidosis in Korea.
Adult ; Asia, Southeastern ; Australia ; Bacterial Infections ; Burkholderia pseudomallei* ; Burkholderia* ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Korea ; Lung ; Malaysia ; Melioidosis ; Middle Aged ; Pneumonia* ; Sepsis*

Burkholderia cepacia is a Gram-negative aerobic bacillus known to cause opportunistic infections in the immune-compromised hosts. This microorganism is strongly virulent and causes a necrotising invasive infection that may lead to death. As B. cepacia is highly resistant to various antimicrobials, combination antimicrobial therapy must be used instead of monotherapy. We report a successful treatment of lung abscess that was naturally caused by B. cepacia in a healthy child, through combination antimicrobial therapy of meropenem and trimethoprim/sulfamethoxazole and operative management.
Bacillus ; Burkholderia cepacia* ; Burkholderia* ; Child* ; Humans ; Lung Abscess* ; Lung* ; Opportunistic Infections

Melioidosis is a life-threatening disease caused by Burkholderia pseudomallei , which is endemic in Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, septicemia, or abscesses of soft tissue or various organs. However, soft tissue abscess associated with bacteremia, especially those found in the head and neck, are rarely reported. We report a case of disseminated septicemia due to Burkholderia pseudomallei presenting as head and neck abscesses in a 55-year-old Korean man with a history of working in Malaysia. This is the first report of fatal melioidosis presenting as a complicated skin and soft tissue infection, in Korea.
Abscess ; Asia, Southeastern ; Australia ; Bacteremia ; Burkholderia pseudomallei ; Head ; Humans ; Korea ; Malaysia ; Melioidosis ; Middle Aged ; Neck ; Osteomyelitis ; Sepsis ; Skin ; Soft Tissue Infections

Burkholderia cepacia is an important pathogen of humans in both immunocompromised or hospitalized patients. This aerobic gram-negative rod causes various clinically significant infections such as pneumonia, bacteremia, urinary tract infection, peritonitis, endophthalmitis, and keratitis. This uncommon pathogen is mainly associated with cystic fibrosis, dialysis, and immunocompromised states. We observed a 73-year-old woman without any underlying diseases, who had both lower leg pain and fever. She was later found to have spondylitis with epidural abscess at L5-S1. Culture of the epidural abscess revealed the growth of B. cepacia. To the best of our knowledge, this is the first case of pyogenic spondylitis caused by a rare infection of B. cepacia to be reported in Korea
Adult ; Aged ; Bacteremia ; Burkholderia ; Burkholderia cepacia ; Cystic Fibrosis ; Dialysis ; Endophthalmitis ; Epidural Abscess ; Female ; Fever ; Humans ; Keratitis ; Korea ; Leg ; Peritonitis ; Pneumonia ; Spondylitis ; Urinary Tract Infections

Burkholderia cepacia is an important pathogen of humans in both immunocompromised or hospitalized patients. This aerobic gram-negative rod causes various clinically significant infections such as pneumonia, bacteremia, urinary tract infection, peritonitis, endophthalmitis, and keratitis. This uncommon pathogen is mainly associated with cystic fibrosis, dialysis, and immunocompromised states. We observed a 73-year-old woman without any underlying diseases, who had both lower leg pain and fever. She was later found to have spondylitis with epidural abscess at L5-S1. Culture of the epidural abscess revealed the growth of B. cepacia. To the best of our knowledge, this is the first case of pyogenic spondylitis caused by a rare infection of B. cepacia to be reported in Korea
Adult ; Aged ; Bacteremia ; Burkholderia ; Burkholderia cepacia ; Cystic Fibrosis ; Dialysis ; Endophthalmitis ; Epidural Abscess ; Female ; Fever ; Humans ; Keratitis ; Korea ; Leg ; Peritonitis ; Pneumonia ; Spondylitis ; Urinary Tract Infections

Burkholderia cepacia is a highly virulent pathogen known to cause opportunistic infections in immunocompromised patients. It accelerates lung disease and causes necrotizing pneumonia with associated severe sepsis, known as cepacia syndrome. In particular, lung transplant recipients infected with Burkholderia cepacia show higher mortality after lung transplantation than those who are not infected with this organism. Due to broad-spectrum antibiotic resistance, a combination therapy should be used according to the results of the susceptibility test. This bacterial infection is rare in Korea, and no case was reported in lung transplant recipients. However, we report a case of pneumonia caused by Burkholderia cepacia after lung transplantation. As Burkholderia cepacia was grown from a sputum culture, the patient was treated initially with a combination of meropenem and trimethoprim/sulfamethoxazole and then ceftazidime and trimethoprim/sulfamethoxazole as a result of leukopenia. After antibiotics treatment for 20 days, sputum cultures became negative for Burkholderia cepacia and the patient successfully recovered.
Anti-Bacterial Agents ; Bacterial Infections ; Burkholderia ; Burkholderia cepacia ; Ceftazidime ; Cystic Fibrosis ; Drug Resistance, Microbial ; Humans ; Immunocompromised Host ; Korea ; Leukopenia ; Lung ; Lung Diseases ; Lung Transplantation ; Opportunistic Infections ; Pneumonia ; Sepsis ; Sputum ; Thienamycins

Burkholderia cepacia is an important opportunistic pathogen in immunocompromised and nosocomial patients, but this bacterial infection is rare in Korea. We report a case of Burkholderia cepacia peritonitis in a patient on CAPD. A 69-year-old male on CAPD for 5 years was presented with turbid peritoneal dialysate, diffuse abdominal pain and diarrhea. He was treated initially with intraperitoneal cefazolin and ceftazidime, and then intraperitoneal meropenem and oral TMP/SMX. His symptoms had improved with antibiotic treatment, but white blood cell counts of dialysate increased, instead. Burkholderia cepacia was isoloated from peritoneal fluid culture. The patient refused catheter removal in spite of our recommendation. He died of suddenly developed acute myocardial infarction and upper gastrointestinal bleeding. Catether tip culture also revealed Burkholderia cepacia.
Abdominal Pain ; Aged ; Ascitic Fluid ; Bacterial Infections ; Burkholderia cepacia* ; Burkholderia* ; Catheters ; Cefazolin ; Ceftazidime ; Diarrhea ; Hemorrhage ; Humans ; Korea ; Leukocyte Count ; Male ; Myocardial Infarction ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Burkholderia cepacia (B. cepacia) infection is rarely reported in an immunocompetent host. It is a well known occurence in patients with cystic fibrosis and chronic granulomatous disease where it increases both morbidity and mortality. It has also been included in the list of organisms causing nosocomial infections in an immunocompetent host, most of them transmitted from the immunocompromised patient in which this organism harbors. We report a rare case of isolation of B. cepacia from the bronchoalveolar lavage fluid of an immunocompetent agriculturist who presented with productive cough and fever associated with a pyopneumothorax. This is the first case of community acquired infection reported in an immunocompetent person in India.
Adult ; Anti-Bacterial Agents ; therapeutic use ; Azithromycin ; therapeutic use ; Bronchoalveolar Lavage Fluid ; microbiology ; Burkholderia Infections ; diagnosis ; drug therapy ; transmission ; Burkholderia cepacia ; drug effects ; isolation & purification ; Ceftazidime ; therapeutic use ; Ceftizoxime ; therapeutic use ; Community-Acquired Infections ; diagnosis ; drug therapy ; Drug Resistance, Multiple, Bacterial ; Humans ; Immunocompetence ; India ; Male ; Pneumothorax ; complications

PURPOSE: Burkholderia cepacia is an aerobic, glucose-non-fermenting, gramnegative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. METHODS: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. RESULTS: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28. 6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. CONCLUSION: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.
Amikacin ; Aminoglycosides ; Anti-Infective Agents ; Bacillus ; Burkholderia cepacia* ; Burkholderia* ; Catheters ; Causality ; Ceftazidime ; Child* ; Colistin ; Heart Defects, Congenital ; Humans ; Incidence ; Intensive Care Units ; Medical Records ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Seoul ; Tertiary Care Centers ; Urinary Bladder ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux