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Volume 26, Number 3—March 2020
Research Letter

Three New Cases of Melioidosis, Guadeloupe, French West Indies

Bénédicte MelotComments to Author , Sylvaine Bastian, Nathalie Dournon, Eric Valade, Olivier Gorgé, Anne Le Fleche, Charlotte Idier, Mireille Vernier, Elisabeth Fernandes, Bruno Hoen, Sébastien Breurec, and Michel Carles
Author affiliations: University Hospital of Guadeloupe, Pointe-à-Pitre, France (B. Melot, S. Bastian, N. Dournon, C. Idier, B. Hoen, S. Breurec, M. Carles); Ecole du Val-de-Grâce, Paris, France (E. Valade); Aix Marseille University, Marseille, France (E. Valade, O. Gorgé); Institut Pasteur, Paris (A. Le Fleche); Hospital of Basse-Terre, Basse-Terre, France (M. Vernier, E. Fernandes); Pasteur Institute of Guadeloupe, Pointe-à-Pitre (S. Breurec); University of the French West Indies and French Guiana, Pointe-à-Pitre (B. Hoen, S. Breurec, M. Carles)

Main Article

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.

Main Article

Page created: February 20, 2020
Page updated: February 20, 2020
Page reviewed: February 20, 2020
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