Description of two fatal cases of melioidosis in Mexican children with acute pneumonia: case report

Abstract

Background Melioidosis is an infectious disease caused by Burkholderia pseudomallei. In Mexico, the disease is rarely diagnosed in humans and there is no evidence of simultaneous environmental isolation of the pathogen. Here, we describe clinical profiles of fatal cases of melioidosis in two children, in a region without history of that disease. Case presentation About 48 h before onset of symptoms, patients swam in a natural body of water, and thereafter they rapidly developed fatal septicemic illness. Upon necropsy, samples from liver, spleen, lung, cerebrospinal fluid, and bronchial aspirate tissues contained Burkholderia pseudomallei. Environmental samples collected from the locations where the children swam also contained B. pseudomallei. All the clinical and environmental strains showed the same BOX-PCR pattern, suggesting that infection originated from the area where the patients were swimming. Conclusions The identification of B. pseudomallei confirmed that melioidosis disease exists in Sonora, Mexico. The presence of B. pseudomallei in the environment may suggest endemicity of the pathogen in the region. This study highlights the importance of strengthening laboratory capacity to prevent and control future melioidosis cases.

Epidemiological and Clinical Characteristics of Melioidosis Caused by Gentamicin-SusceptibleBurkholderia pseudomalleiin Sarawak, Malaysia

“…Melioidosis is an important cause of infectious disease mortality in the Western Pacific region and in Southeast Asia (SEA) [ 1 , 2 ]. Although historically known to be endemic to SEA and northern Australia, cases are now increasingly being reported worldwide [ 3 , 4 ]. Melioidosis is caused by the environmental saprophyte Burkholderia pseudomallei ( Bp ), a gram-negative bacillus that is intrinsically resistant to a broad range of antibiotics, including aminoglycosides [ 5 ].…”

Burkholderia species in human infections in Mexico: Identification of B. cepacia, B. contaminans, B. multivorans, B. vietnamiensis,B. pseudomallei and a new Burkholderia species

“…pseudomallei might lead to successful treatment of the patient. Unfortunately, this this did not happen in two fatal cases in northern Mexico; since the melioidosis caused by B. pseudomallei is barely known in Mexico, correct antibiotic treatment was not provided to the children, who died within a few hours after the admission to a hospital [20].…”

“…The disease produced by B. pseudomallei, melioidosis, is present in Mexico, but it is a neglected disease because it is not accurately identified and reported. Recent cases with fatal outcomes [19,20], suggest that greater awareness of this bacterium and the disease is needed to prepare the health care staff to deal with the disease. Since the distribution of B. pseudomallei is worldwide, an increasing interest has emerged in the origin of B. pseudomallei strains.…”

“…B. pseudomallei has been isolated from pediatric patients with pneumonia in Mexico, but melioidosis was not diagnosed at any time [12]. We recently related environmental B. pseudomallei to two fatal cases of melioidosis in Sonora, Mexico [20]. Although Sonora is not tropical (located in northwest Mexico), the presence of B. pseudomallei in stressful conditions has been documented previously [21], including in desert regions [22].…”

“…We recently related environmental B . pseudomallei to two fatal cases of melioidosis in Sonora, Mexico [ 20 ]. Although Sonora is not tropical (located in northwest Mexico), the presence of B .…”