Case ReportSniff the Plates? Laboratory Exposure to Burkholderia pseudomallei
Introduction
Burkholderia pseudomallei, a category B bioterrorism agent, is endemic in Asia and Australia (1). The organism can cause melioidosis with a clinical presentation ranging from localized infection to pneumonia and septicemia. Because cases of this disease are rare in the United States, proper safety precautions may not be observed when handling the agent unknowingly in the laboratory. We report a case of melioidosis in a 27-year-old male who presented with localized neck swelling and later developed complications due to the patient's non-compliance with his antibiotic therapy.
Section snippets
Case Report
A 27-year-old male from southern India presented in the emergency room with swelling of his left neck, which had increased over a 4-week period. He had no fever, chills, weight loss, nausea, vomiting, or diarrhea but complained of a bilateral skin rash on his anterior shins. While the patient was employed in the U.S., he made frequent trips to southern India to visit family. His physical examination was normal except for a left neck mass and a desquamating rash on the anterior surfaces of both
Discussion
B. pseudomallei is a facultative, intracellular, gram-negative rod that causes melioidosis. Melioidosis is uncommon in the U.S. with approximately five cases reported each year, but areas of endemicity are in northern Australia and Southeast Asia. Most cases are found in Thailand, Malaysia, Singapore, and northern Australia. Outside of these regions, cases are typically due to recent travel to areas of endemicity, though there have been occasional cases reported in tropical areas, including
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