J Korean Med Sci.  2005 Feb;20(1):139-142. 10.3346/jkms.2005.20.1.139.

A Case of Melioidosis Presenting as Migrating Pulmonary Infiltration: The First Case in Korea

• Lee SW
• Yi J
• Joo SI
• Kang YA
• Yoon YS
• Yim JJ
• Yoo CG
• Han SK
• Shim YS
• Kim EC
• Kim YW

• KMID: 1781741
• DOI: http://doi.org/10.3346/jkms.2005.20.1.139

Abstract

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.

Keyword

Melioidosis; Burkholderia pseudomallei; Korea; Communicable Diseases; Lung Diseases

MeSH Terms

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

Figure

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  Fig. 1 Initial CPA and CT images show multiple infiltrations in the left upper and lower lobes.

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  Fig. 2 Three months later, a new infiltration appears in the left lower lobe and lesions in the left upper and lower lobes improved.

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  Fig. 3 The colonies develop a rugose appearance, and they take up violet dye from medium after 2 days at 35℃.

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  Fig. 4 Gram stain shows Gram-negative safety pin shaped organisms (×1,000).

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