We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Fatal urosepsis due to delayed diagnosis of genitourinary melioidosis.
- Authors
Frickmann, Hagen; Neubauer, Heinrich; Haase, Gerhard; Peltroche-Llacsahuanga, Heidrun; Pérez-Bouza, Alberto; Racz, Paul; Loderstaedt, Ulrike; Hagen, Ralf M.
- Abstract
Background: Two months after a vacation in Thailand, a 54-year-old alcohol-addicted diabetes patient was admitted to hospital presenting with a febrile, therapy-refractory urinary tract infection. Burkholderia pseudomallei was cultured from urine but misidentified as Burkholderia cepacia. Application of inappropriate chemotherapy provoked systemic spread of bacteria from urinary tract abscesses. Septic shock and respiratory failure resulted in a fatal outcome. Results: Correct identification at the species level was achieved by 16S rRNA gene sequencing. Postmortem, B. pseudomallei was additionally detected in prostatic tissue by PCR and fluorescence in situ hybridization. Conclusions: Biochemical differentiation of bacteria of the genus Burkholderia is not reliable at the species level. Molecular approaches should be added if an infection with B. pseudomallei is probable according to clinical anamnesis. The recommended dosage of antibiotic drugs should be at the upper limit if abscess formation is likely.
- Subjects
ANTIBIOTICS; COMBINATION drug therapy; DIAGNOSIS; DIAGNOSTIC errors; MEDICAL errors; SEPSIS; TRAVEL; URINARY tract infections; FLUORESCENCE in situ hybridization; TREATMENT effectiveness; BURKHOLDERIA; BURKHOLDERIA infections; GENE expression profiling
- Publication
Journal of Laboratory Medicine / Laboratoriums Medizin, 2013, Vol 37, Issue 4, p-
- ISSN
0342-3026
- Publication type
Article
- DOI
10.1515/labmed-2012-0050