A 42-year-old man with diabetes mellitus and hypertension,
which were under medical control for 5 years, had right leg
necrotizing fasciitis for months. He received debridement surgery
several times. Wound culture grew Burkholderia pseudomallei.
Abdominal computed tomography showed a splenic abscess, and
a splenectomy was performed. Histopathology showed granulomatous inflammation, with caseous-like necrosis, consistent with
melioidosis (Fig.1). Melioidosis, caused by the Gram-negative bacilli
B pseudomallei, is an important cause of septicemia in southeast
Asia, including China, Taiwan and northern Australia. This chronic
persistent infection has a high mortality rate.B pseudomalleiis an
environmental saprophyte found in wet soils. It mostly infects
adults with an underlying predisposing background, mainly, as in
this patient, diabetes mellitus. Melioidosis is histopathologically
characterized by suppurative granulomas in the lungs, liver and
spleen. The diagnosis relies on culture, as in our case. Even after
extensive antibiotic therapy, the disease may relapse
A 42-year-old man with diabetes mellitus and hypertension,which were under medical control for 5 years, had right legnecrotizing fasciitis for months. He received debridement surgeryseveral times. Wound culture grew Burkholderia pseudomallei.Abdominal computed tomography showed a splenic abscess, anda splenectomy was performed. Histopathology showed granulomatous inflammation, with caseous-like necrosis, consistent withmelioidosis (Fig.1). Melioidosis, caused by the Gram-negative bacilliB pseudomallei, is an important cause of septicemia in southeastAsia, including China, Taiwan and northern Australia. This chronicpersistent infection has a high mortality rate.B pseudomalleiis anenvironmental saprophyte found in wet soils. It mostly infectsadults with an underlying predisposing background, mainly, as inthis patient, diabetes mellitus. Melioidosis is histopathologicallycharacterized by suppurative granulomas in the lungs, liver andspleen. The diagnosis relies on culture, as in our case. Even afterextensive antibiotic therapy, the disease may relapse
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