Case Report: Gestational Melioidosis through Perinatal Transmission

Rodríguez, José Yesid; Huertas, Mónica Gabriela; Rodríguez, Gerson J.; Vargas-Otalora, Sandra; Benıtez-Peñuela, Miguel A.; Esquea, Kelin; Ríos, Rafael; Mendoza, Laura R.; Diaz, Lorena; Reyes, Jinnethe; Álvarez-Moreno, Carlos

doi:10.4269/ajtmh.20-0223

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…As a result of the immune escape of B. pseudomallei , the changed incubation period, the difference in the number of bacteria in the tissue, and the interference of other pathogens on bacterial culture, multitissue and repeated bacterial culture can prevent a missed diagnosis [ 22 , 23 ]. A positive case of placental drainage was also found, and in the past, there were similar rare cases of neonatal transmission through breastfeeding and premature birth caused by pregnancy-associated infections [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 75%

Risk Factors for Melioidosis Mortality and Epidemics: A Multicentre, 10-Year Retrospective Cohort Study in Northern Hainan

et al. 2023

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Introduction Burkholderia pseudomallei is a gram-negative environmental bacterium and aetiological agent of melioidosis, a tropical infectious disease with diverse clinical presentations. We aimed to describe the epidemiological and clinical characteristics of melioidosis in northern Hainan and to determine the meteorological factors affecting its morbidity. Methods We conducted a retrospective, multicentre, observational cohort study of 90 patients with melioidosis admitted to four general hospitals in northern Hainan from 2010 to 2020. Epidemiological, clinical presentation, laboratory and treatment outcome data were collected and analysed. The monthly incidence of melioidosis and meteorological data, including precipitation, temperature, humidity, air pressure and wind speed, for the same period were collected to analyse the relationship between meteorological factors and the incidence of melioidosis. Results Of the 90 patients included in the study, 79 (87.78%) were male. Patient age ranged from 10 to 81 years old, but most patients, namely, 78 (86.67%), were middle-aged and elderly people aged 41–81 years old. Forty-six patients (51.11%) were farmers. The number of cases increased significantly after 2014, with the highest numbers occurring in 2014 and 2016. The highest number of cases occurred in summer and autumn and were associated with abundant rainfall, and 58 cases (64.44%) occurred from July to December. The patients showed diverse presentations and abnormal laboratory parameters: 69 patients (76.67%) had a history of diabetes mellitus; bacteremia was present in 50 patients (55.56%), sepsis was present in 39 patients (43.33%) and pneumonia in 19 patients (21.11%). An average high-sensitivity C-reactive protein (hs-CRP) level of 149.57 ± 13.65 mg/L and a median procalcitonin (PCT) level of 1.31 (0.39, 6.21) ng/mL were observed. Among all the cases, 21 (23.33%) were identified as acute infections, 51 (56.67%) as subacute infections and 18 (20.00%) as chronic infections. Six patients (6.67%) died of illness; five of these patients were male, and five of these patients were middle-aged and elderly patients. The monthly average precipitation was significantly positively correlated with the monthly average incidence of melioidosis ( r = 0.74, P < 0.01). Conclusion Male patients, farmers and especially middle-aged and elderly individuals with a history of diabetes mellitus accounted for most of the patients. The majority of cases were concentrated in coastal areas. Most cases of melioidosis occurred during the rainy seasons, and the monthly average precipitation was an independent factor affecting the average monthly incidence of melioidosis.

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Section: Discussionmentioning

confidence: 75%

Risk Factors for Melioidosis Mortality and Epidemics: A Multicentre, 10-Year Retrospective Cohort Study in Northern Hainan

et al. 2023

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“…It is unknown whether pregnant women are more susceptible to infection, or whether they experience more severe disease compared to non-pregnant women. Reported cases in pregnancy include a case of perinatal transmission at 32 weeks of gestation where melioidosis was diagnosed postpartum, a fatal case of bronchopneumonia complicated with spontaneous abortion at 16 weeks of gestation, a case of chorioamnionitis with preterm delivery at 23 weeks of gestation and a case of bacteraemic melioidosis with splenic abscess in a young healthy woman complicated with early fetal loss at 6 weeks of gestation [16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

A rare and fatal case of tubo-ovarian abscess due to Burkholderia pseudomallei presenting as puerperal sepsis

Bhaskar M,

Rajamanikam,

Raj

et al. 2023

Access Microbiology

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Introduction. Melioidosis is an emerging life-threatening infectious disease caused by the Gram-negative Burkholderia pseudomallei found in contaminated soil and surface ground water. It often presents with varied clinical manifestations and has a high mortality if left untreated due to lack of clinical suspicion. Here we report a rare and fatal case of tubo-ovarian abscess presenting as puerperal sepsis due to B. pseudomallei in a young woman. Case report. A 25-year-old female presented for medical consultation at day 43 postpartum complaining of fever on and off for the past 40 days associated with vomiting. On per speculum examination, greenish discharge from the cervix was seen and a right adnexal mass was felt which was cystic in consistency, non-tender and pushing the cervix to the left side. An exploratory laparotomy was carried out and pus was drained from below the rectus sheath, and from the right tubo-ovarian mass. Peripheral blood and the pus samples collected intraoperatively grew B. pseudomallei . The patient died on the fifth post-operative day due to septic shock with disseminated intravascular coagulation secondary to puerperal sepsis. Conclusion. Melioidosis is a fatal but treatable disease when it is promptly diagnosed. In countries such as India, where tuberculosis is highly endemic, underdiagnosis of melioidosis can be common. Clinicians and microbiologists should have a high index of suspicion of melioidosis especially in individuals with underlying illness.

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