Volume 26, Number 3—March 2020
Research Letter
Three New Cases of Melioidosis, Guadeloupe, French West Indies
Table
Main comparative data for 3 cases of melioidosis in Guadeloupe, French West Indes*
Characteristic | Patient 1 | Patient 2 | Patient 3 |
---|---|---|---|
Age, y |
54 |
66 |
52 |
Sex |
M |
F |
M |
Place of birth |
Guadeloupe |
Guadeloupe |
Guadeloupe |
Place of residence |
Bouillante |
Deshaies |
Les Saintes |
Rainfall, mm/y |
2,500–3,000 |
1,500–2,000 |
1,500–2,000 |
Concurrent conditions |
Chronic renal failure (vascular nephropathy) |
Diabetes |
Chronic alcohol intake |
Possible means of inoculation |
Gardening without gloves |
Animals breeding, gardening without gloves |
Animals breeding, gardening without shoes |
Clinical presentation according to the Infectious Disease Association of Thailand† |
1: Multifocal infection with bacteremia (45% of cases, 87% mortality) |
3: Localized infection (42% of cases, 9% mortality) |
3: Localized infection (42% of cases, 9% mortality) |
Time from first clinical signs to death |
11 mo |
2 mo |
16 mo |
Organ involvement |
Pneumonia |
Disseminated (psoas abscess, lung abscesses, bacteremia) |
Pneumonia |
MLST |
ST92 |
ST95 |
ST92 |
Treatment |
Ceftazidime + TMP/SMX, then doxycycline; TMP/SMX discontinued due to rash |
Ceftazidime, meropenem, TMP/SMX |
Ceftazidime + TMP/SMX; TMP/SMX discontinued due to DRESS syndrome |
Outcome | Death | Death | Death |
*DRESS, drug reaction with eosinophilia and systematic symptoms; MLST, multilocus sequence typing; ST, sequence type; TMP/SMX, trimethoprim/sulfamethoxazole.
†Punyagupta S. Melioidosis: review of 686 cases and presentation of a new clinical classification. In: Punyagupta S, Sirisanthana T, Stapatayavong B, eds. Melioidosis. Bangkok: Bangkok Medical; 1989:217–29; Leelarasamee A, Bovornkitti S. Melioidosis: review and update. Rev Infect Dis. 1989;
11:413–25.