A case of pulmonary melioidosis in Germany: a rare differential diagnosis in returning travelers from South-East Asia.

Autor: Gottschalk C; Department of Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.; German Centre for Infection Research (DZIF), Heidelberg University Hospital Partner Site, Heidelberg, Germany., Stojković M; Department of Infectious Diseases and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany., Zange S; Bundeswehr Institute of Microbiology, Munich, Germany.; German Centre for Infection Research (DZIF), Munich Partner Site, Munich, Germany., Wolf P; Department of Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany., Klein JAF; Department of Virology, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany. julian.klein@med.uni-heidelberg.de.
Jazyk: angličtina
Zdroj: Infection [Infection] 2024 Oct; Vol. 52 (5), pp. 1671-1676. Date of Electronic Publication: 2024 Apr 26.
DOI: 10.1007/s15010-024-02253-6
Abstrakt: Background: Melioidosis is a bacterial infection associated with high mortality. The diagnostic approach to this rare disease in Europe is challenging, especially because pulmonary manifestation of melioidosis can mimic pulmonary tuberculosis (TB). Antibiotic therapy of melioidosis consists of an initial intensive phase of 2-8 weeks followed by an eradication therapy of 3-6 months.
Case Presentation: We present the case of a 46-year-old female patient with pulmonary melioidosis in Germany. The patient showed chronic cough, a pulmonary mass and a cavitary lesion, which led to the initial suspicion of pulmonary TB. Melioidosis was considered due to a long-term stay in Thailand with recurrent exposure to rice fields.
Results: Microbiologic results were negative for TB. Histopathology of an endobronchial tumor showed marked chronic granulation tissue and fibrinous inflammation. Melioidosis was diagnosed via polymerase chain reaction by detection of Burkholderia pseudomallei/mallei target from mediastinal lymph-node tissue.
Conclusion: This case report emphasizes that melioidosis is an important differential diagnosis in patients with suspected pulmonary tuberculosis and recent travel to South-East Asia.
(© 2024. The Author(s).)
Databáze: MEDLINE
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