Mycotic aneurysm caused by Burkholderia pseudomallei: report of a Brazilian strain genetically related to Thai strains

Sidrim, J. J. C.; Rocha, Marcos F.G.; Bandeira, Tereza J. P. G.; Cordeiro, Rossana de Aguiar; Carvalho, B. M.; Grangeiro, Thalles Barbosa; Holanda, M.A.; Lima, Rita Amanda Chaves de; Valente, Luca; Costa, Ana; Brilhante, Raimunda Sâmia Nogueira

doi:10.1111/j.1469-0691.2010.03405.x

Cited by 6 publications

(9 citation statements)

References 19 publications

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“…Presently, positive blood culture together with a radiological abnormality of the artery in the abdomen and pelvis (mainly on CT imaging) strongly suggests an infected mycotic aneurysm [19]. Herein, in our cases, at least one organ imaging abnormality was present in the intra-abdominal organs supplied by the abdominal aorta.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 47%

“…In 2011 the Institute for Communicable Disease Control and Prevention of China established a working group to monitor the epidemiology of melioidosis throughout China, revealing the overwhelming majority of culture-confirmed cases were from Hainan (99.0%, 392/396, 3 from Guangxi and 1 from Guangdong) between 2002 and 2016, and septicaemia was the most common clinical manifestation (153/277, 55.2%) [15].Taken together, the mycotic aneurysm cases collected in Hainan Province in the present study can represent the general epidemiological features in China. It is documented that most patients with infected mycotic aneurysm secondary to melioidosis are male and aged 60 years [1,2,12,19]. Similarly, in our case series, the ages of eight subjects ranged from 48 to 69, with a median age of 61.5 years, all were indigenous males, and two [24], Case 12-14 [25], Case 15 [26], Case 16 [3], Case 17 [27], Case 18 [28], Case 19 [29], Case 20 [30], Case 21 [31], Case 22 [19], Case 23-24 [6], and Case 25-26 [10], Case 27 [52], Case 28 [18], Case 29 [32], Case 30 [33], Case 31 [41], Case 32 [35], Case 33 [36], Case 34 [8] Case 35 [37], Case36 [38], Case37 [39], and Case38 [40].…”

Section: Discussionmentioning

confidence: 99%

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Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Wang

Zhou

et al. 2020

PLoS Negl Trop Dis

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Burkholderia pseudomallei is the causative agent of melioidosis, endemic in Southeast Asia and Northern Australia, and increasingly recognized in southern China, especially in Hainan Province. Mycotic aneurysm caused by B. pseudomallei is a rare but potentially severe illness with a high mortality rate. The clinical features of the mycotic aneurysm secondary to melioidosis have not been illustrated in China. Over a seven-year period (2013 to 2019), 159 patients with bacteremic melioidosis were retrospectively analyzed in Hainan province, China, of whom eight patients were confirmed to have mycotic aneurysm through the combination of imaging examination, pathologic examination and aneurysm tissue culture. We summarized these eight patients' clinical characteristics, demographical features, treatments and outcomes. The susceptibilities to five commonly-used antibiotics for these eight B. pseudomallei isolates were also determined by E-test strips. Furthermore, the mycotic aneurysm cases secondary to melioidosis retrieved from the literature were also reviewed. Of the eight cases, six had abdominal mycotic aneurysms, one had a left iliac aneurysm, and the other one had an infectious mesenteric aneurysm. They were aged from 48 to 69 years old, and had the underlying risk factors of diabetes mellitus (2 patients), long-term smoking (4 patients), hypertension (6 patients), and soil and water contact history (6 patients), respectively. The positive arterial aneurysm imaging was observed in all patients via computed tomography (CT) or angiography. Eight B. pseudomallei isolates collected from both blood and mycotic aneurysm tissues remained 100% susceptible to imipenem and ceftazidime. After surgery combined with antibiotic administration, six patients survived, with a mortality rate of 25%. In melioidosis endemic areas, the mycotic aneurysm secondary to melioidosis might be underdiagnosed, and increased awareness of predisposing risk factors and clinical features of the mycotic aneurysm is required. Following a positive B. pseudomallei blood culture, the diagnosis of mycotic aneurysm should be under consideration in PLOS NEGLECTED TROPICAL DISEASES

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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Wang

Zhou

et al. 2020

PLoS Negl Trop Dis

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“…Melioidosis is particularly common in Northeast Thailand and ranks as the third most common cause of death from infectious diseases, only exceeded by HIV and tuberculosis 1. Despite increasing reports of melioidosis worldwide, the distribution and frequency of melioidosis is probably still greatly underestimated, especially in resource poor settings 2 6 7. Moreover, B. pseudomallei has a potential latency of infection and may present itself years after exposure 1…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, only very few reports exist of mycotic aneurysms by B. pseudomallei in returning travellers without any established risk factors,14 15 but mycotic aneurysms have been described in travellers with risk factors16 and in endemic areas such as Australia,12 Southeast Asia4 8 17 and Brazil 7…”

Section: Discussionmentioning

confidence: 99%

Mycotic aneurysm caused byBurkholderia pseudomalleiin a previously healthy returning traveller

et al. 2014

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Burkholderia pseudomalleiis a common cause of serious, difficult to treat infections in South-East Asia and Northern Australia, but is a rare imported pathogen in the USA and Europe. We report a case of a patient with a mycotic aneurysm caused byB. pseudomalleiin a previously healthy returning traveller. The patient presented with 4 weeks of abdominal pain and intermittent fever after a brief vacation in Thailand. The aneurysm was excised and replaced by an autologous deep vein graft, and the patient was treated for 6 months with antibiotics adjusted according to postoperative renal impairment. Twenty-four months after surgery the patient is well and without relapse.

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“…Four siblings acquired acute infection after recreational exposure at the town dam and three of them died within a week [ 7 , 8 , 9 , 10 ]. By 2017, 30 cases had been diagnosed in Ceará [ 2 , 11 , 15 , 16 , 17 , 18 , 23 ]. Characterisation of clinical and environmental B. pseudomallei from Ceará showed that considerable genetic diversity is present [ 30 ].…”

Section: Review Of Published Melioidosis Cases and The Presence Ofmentioning

confidence: 99%

Melioidosis in South America

et al. 2018

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Melioidosis is an emerging disease in the Americas. This paper reviews confirmed cases, the presence of Burkholderia pseudomallei and the organization of national surveillance policies for melioidosis in South America. Confirmed cases in humans have been reported from Ecuador, Venezuela, Colombia, Brazil, and Peru. The bacterium has been isolated from the environment in Brazil and Peru. The state of Ceará, northeastern region of Brazil, is the only place where specific public strategies and policies for melioidosis have been developed. We also discuss the urgent need for health authorities in South America to pay greater attention to this disease, which has the potential to have a high impact on public health, and the importance of developing coordinated strategies amongst countries in this region.

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Mycotic aneurysm caused by Burkholderia pseudomallei: report of a Brazilian strain genetically related to Thai strains

Cited by 6 publications

References 19 publications

Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Mycotic aneurysm secondary to melioidosis in China: A series of eight cases and a review of literature

Mycotic aneurysm caused byBurkholderia pseudomalleiin a previously healthy returning traveller

Melioidosis in South America

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