![]() Within 48 h of transfer, the patient underwent surgical excision of the mycotic aneurysm and reconstruction of her aorta using bioprosthetic homografts. On arrival, two sets of blood cultures (BD Bactec FX system Becton, Dickinson and Company, NJ) were collected. The patient was transferred to our institution for surgical evaluation. Follow-up CT scans performed 9 days after presentation showed that the mycotic aneurysm had enlarged to 13 by 24 by 20 mm and revealed a second aneurysm of the lateral wall of the aorta measuring 4 by 4 mm. ![]() The patient was treated with meropenem 1 g intravenously (i.v.) every 8 hours (q8h). Transthoracic echocardiography showed no vegetation. This identification was confirmed several weeks later by the Centers for Disease Control and Prevention (CDC). Blood cultures drawn in the emergency department grew a Gram-negative rod, which was identified by the Vitek 2 (bioMérieux, Durham NC) as Burkholderia pseudomallei. She was admitted to an outside hospital on this visit and computed tomography (CT) of the abdomen and pelvis with intravenous contrast revealed an 8 by 8 by 8 mm suprarenal saccular aneurysm arising from the posterior aortic wall with surrounding inflammation. She was evaluated in different emergency departments for similar complaints on two occasions in the preceding week, but was discharged home. pseudomallei or clinical specimens from suspected melioidosis cases.Ī 67-year-old Filipino woman with a previous history of treated tuberculosis, hypertension, type 2 diabetes, coronary artery disease, and complete heart block requiring a pacemaker and drug-eluting stent that was placed 4 months earlier presented to an outside hospital with 2 weeks of progressive left lower quadrant abdominal pain, chills, and subjective fever. In this minireview, we report a case of melioidosis encountered at our institution and discuss the laboratory challenges encountered when dealing with clinical isolates suspicious for B. pseudomallei, be able to safely perform necessary rule-out tests, and to refer suspect isolates to Laboratory Response Network reference laboratories. Department of Agriculture Animal and Plant Health Inspection Service, clinical laboratories must be proficient at rapidly recognizing isolates suspicious for B. Since the organism is considered a tier 1 select agent according to the Centers for Disease Control and Prevention and the U.S. ![]() Although the disease is more prevalent in Thailand and northern Australia, sporadic cases may be encountered in areas where it is not endemic, including the United States. Clinical diagnosis of melioidosis can be challenging since there is no pathognomonic clinical syndrome, and the organism is often misidentified by methods used routinely in clinical laboratories. ![]() Melioidosis is a potentially fatal infection caused by the bacterium Burkholderia pseudomallei. ![]()
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