With prompt administration of appropriate antimicrobial therapy and access to modern intensive care support, fatal pediatric melioidosis is very unusual. We describe cases of two children in whom the possibility of melioidosis was recognized relatively early, but who died of the disease, despite receiving optimal supportive care. We discuss the resulting implications for bacterial virulence factors in disease pathogenesis.
In many parts of the world, the case-fatality rate of infection approaches 60%. To evaluate the spectrum of disease associated with in Far North Queensland (FNQ), Australia, we reviewed all culture-confirmed isolates from 1997 to 2017. There were 28 isolates, 15 represented infection, 11 were contaminants, and two charts were destroyed preventing detailed evaluation of these cases. The most common sites of infection were the skin and soft tissue and the urinary tract; there were two cases of bacteremia without focus. There were no deaths attributable to during the study period and only two cases required intensive care unit support, although in both patients this was not for the infection, but for the management of other health issues. Globally, has a reputation as a deadly pathogen, but in FNQ, Australia, infections usually follow a relatively benign course.
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