With globalization, foreign patients are frequently encountered at the clinical practice in Korea. As the number of migrant workers from Southeast Asia has been notably rising since the late 1990's, unfamiliar tropical infectious diseases that they bring out, may give great challenges to the routine clinical practice in Korea. Melioidosis is a community-acquired infection caused by a gram-negative bacillus, Burkholderia pseudomallei. It has been endemic in Southeast Asia and Northern Australia, where B. pseudomallei is a soil saprophyte and invades the host through inoculation or inhalation. It frequently presents as an acute septicemia with a high mortality rate of 40%, mainly in patients with chronic underlying diseases, such as diabetes mellitus. Recently, we encountered a case of fatal disseminated melioidosis in a migrant worker from Thailand. We suggest an importance of melioidosis as a cause of community-acquired sepsis in migrant workers from Southeast Asia.
Adult ; *Burkholderia pseudomallei ; Drug Resistance, Multiple ; Humans ; Male ; Melioidosis/*diagnosis/pathology/radiography ; Thailand ; Tomography, X-Ray Computed

Melioidosis is an infection of the Gram-negative bacterium Burkholderia pseudomallei. While it is known as an important cause of sepsis or chronic abscessforming disease in Southeast Asia and northern Australia, no case has yet been reported in Korea. A 50-yr-old man visited our hospital for intermittent fever associated with dry cough and sputum. Roentgenographic examination showed migrating pulmonary infiltration. Symptoms and chest radiograph and computed tomography (CT) image findings did not improve despite use of fluoroquinolone antibiotics. Gram-negative bacteria were isolated on bronchoscopic washing culture and were identified as B. pseudomallei on DNA sequencing of 16S ribosomal RNA with 100% homology. Treatment for melioidosis was commenced with high dose ceftazidime, and the patient's fever, cough, and sputum were improved and the lesion on chest radiograph and CT almost disappeared.
Anti-Bacterial Agents/pharmacology ; Burkholderia pseudomallei/metabolism ; Ceftazidime/pharmacology ; Diagnosis, Differential ; Fluoroquinolones/pharmacology ; Humans ; Korea ; Lung/*microbiology ; Lung Diseases/diagnosis/*microbiology ; Male ; Melioidosis/diagnosis/*pathology ; Middle Aged ; RNA, Ribosomal, 16S/chemistry ; Sepsis ; Sequence Analysis, DNA ; Temperature ; Time Factors ; Tomography, X-Ray Computed