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Imported melioidosis reported in Florida

August 17, 2006

NEW YORK (Reuters Health) – Two cases of melioidosis, an
infectious disease caused by the bacterium Burkholderia
pseudomallei that is rare in the US, were reported to the
Florida Department of Health in 2005. Both patients had
recently visited or arrived from Honduras, where the disease is
endemic. One case resulted in paraplegia, and the other in
death.

In the CDC’s Morbidity and Mortality Report for August 18,
Dr. Aaron Kite-Powell, from the Broward County Health
Department in Florida, and his co-authors note that B.
pseudomallei infection usually manifests as pneumonia, but can
also cause septicemia and abscesses. Relapses are common, and
the infection can be reactivated years later.

B. pseudomallei is found in contaminated water and soil and
is spread to humans and animals through direct contact with the
contaminated source.

Risk factors for symptomatic disease include type 2
diabetes, renal or liver disease and chronic alcoholism.

The first Florida case, a 48-year-old man with a history of
diabetes and Guillain-Barre syndrome, presented at a hospital
in Broward County with back pain, fever, and weakness and
numbness in the legs. He had recently returned from a trip to
Honduras.

He began antibiotic therapy. B. pseudomallei was not
identified until the fifth day of his hospitalization, after
which he was discharged on antibiotic therapy.

Eleven days later, he returned with severe back and chest
pain, acute leg paralysis and loss of sensation. Imaging
studies revealed a spinal abscess, which was treated
surgically.

An 80-year old woman from Honduras was the second case. She
was hospitalized with pneumonia and fever, headache, weakness
and muscle pain. The next day she had a heart attack with
respiratory complications and died the following day. B.
pseudomallei was identified 4 days after her admission.

Follow-up showed that nine laboratory workers had been
exposed to B. pseudomallei under conditions considered to be
high risk, including handling the isolate outside of a
biosafety cabinet and sniffing an open culture plate.
Diagnostic serology showed that none of them were positive for
presence of the bacteria, and none reported symptoms.

SOURCE: Morbidity and Mortality Weekly Report, August 18,
2006.


Source: reuters



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