Severe Disseminated Melioidosis with Pulmonary, Cutaneous, and Osteoarticular Involvement in the Peruvian Amazon.
Mario Agramonte-Vilca, Stefany Alvis-Sanchez, Debora Rocio Mananita-Terrones et al.
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Case in brief
A 35-year-old man with poorly controlled diabetes living in the Peruvian Amazon presented with multifocal pneumonia, bacteremia, and septic shock requiring mechanical ventilation and vasopressors. He subsequently developed cutaneous microabscesses and septic arthritis of the left knee. Burkholderia pseudomallei grew from blood cultures and synovial fluid, confirming disseminated infection. The report describes severe melioidosis involving the lungs, skin, and joint in a region where the disease burden is poorly characterized.
What made this case unusual
The case documents severe disseminated melioidosis in the Peruvian Amazon, with microbiological confirmation from both blood and synovial fluid.
Diagnostic / clinical pearl
In tropical regions, consider B. pseudomallei in severe sepsis, particularly when environmental exposure and metabolic risk factors are present; culture from involved sites can confirm dissemination.
Why it matters
The report highlights the need to strengthen microbiological diagnostic capacity to improve detection of melioidosis in South America.