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Volume 21, Number 5—May 2015
Letter

Melioidosis in Trinidad and Tobago

Catherine Hogan, Amanda Wilmer, Mazen Badawi, Linda Hoang, Michael Chapman, Natasha Press, Kym Antonation, Cindi Corbett, Marc Romney, and Melanie MurrayComments to Author 
Author affiliations: University of Sherbrooke, Sherbrooke, Quebec, Canada (C. Hogan); University of British Columbia, Vancouver, British Columbia, Canada (A. Wilmer, M. Badawi, L. Hoang, M. Chapman, N. Press, M. Romney, M. Murray); King Abdulaziz University, Jeddah, Saudi Arabia (M. Badawi); British Columbia Centre for Disease Control Public Health Microbiology and Reference Laboratory, Vancouver (L. Hoang); St. Paul’s Hospital, Vancouver (N. Press, M. Romney, M. Murray); National Microbiology Laboratory, Winnipeg, Manitoba, Canada (K. Antonation, C. Corbett); British Columbia Women’s Hospital, Vancouver (M. Murray)

Main Article

Table

Published case reports of melioidosis from the Caribbean*

Ref. Site of origin (year) Age, y/sex Type of exposure Concurrent condition Clinical manifestation Diagnostic method Treatment
(duration) Outcome
(3) Panama (1947) 31/M Fall on buttock, TR Polio, spinal meningitis Buttock abscess Abscess culture Sulfathiazole, sulfapyridine, streptomycin, penicillin Survived
(5) Panama (1948) 25/F UNK, TR None Retroperitoneal abscess, sepsis Abscess culture Penicillin, streptomycin Died
(5) Panama (1960) 20/M UNK None Acute septic arthritis Synovial fluid culture Chloramphenicol, novobiocin, sulfisoxazole Survived
(5) Puerto Rico (1982) 62/F UNK Diabetes, SLE, cirrhosis Septic meningitis Blood and CSF culture Penicillin, chloramphenicol, moxalactam, amikacin Died
(5) Mexico (1986) 72/M UNK None Pneumonia, splenic abscess Blood and sputum culture Cefoxitin, gentamicin Died
(5) Martinique (1995) 66/M UNK, resident Diabetes Sepsis Blood and urine culture IV ceftazidime, then oral TMP/SMX and doxycycline (2 mo) Survived
(5) Guadeloupe (1997) 4/M UNK, TR None Pneumonia, pleural effusion, peritonitis Pleural fluid culture IV ceftazidime and TMP/SMX(1 mo), then oral TMP/SMX (6 mo) Survived
(5) Puerto Rico (1997) 11/M UNK, resident X-linked CGD Mediastinitis, lymphadenitis Supraclavicular and hilar biopsy culture Imipenem and doxycycline (6 weeks), oral cefixime and doxycycline (3 wk) Died†
(5) El Salvador (2001) UNK UNK, TR UNK Cerebral abscess UNK UNK Survived
(4) Puerto Rico (2003) 55/F Flood water, resident Diabetes Pneumonia, septic shock Blood and sputum culture Imipenum, amikacin, azithromycin Died
(6) British Virgin Islands (2006) 17/M UNK, resident CF Pneumonia Sputum culture,
PCR UNK Survived
(7) Aruba (2009) 7/F UNK, TR CF Pneumonia Oropharyngeal and induced sputum culture Imipenem and ceftazidime (14 d), then inhaled meropenem (28 d) and long-term oral TMP/SMX Survived
(4) Puerto Rico (2009) 88/M Ditch digging, resident CAD, PVD Pneumonia MLST Doxycycline (20 wk), oral TMP/SMX Survived
(8) Guadeloupe (2010) 15/F UNK, TR Asthma, dengue fever Adenopathy, tumefaction Tumefaction culture
PCR IV ceftazidime (10 d), then oral TMP/SMX (12 wk) Survived
(9) Martinique (2010) 35/M UNK, TR None Diarrhea, pneumonia Blood culture;
PCR Imipenem,
G-CSF Died
(10) Aruba (2012) 46/F Water exposure, TR None Breast abscesses Abscess culture Meropenem (14 d), then oral TMP/SMX (12 wk) Survived
(4) Puerto Rico (2010) 38/M Landscaping, resident None Pneumonia, hepatitis, myocarditis, septic shock Immunohistochemistry with polyclonal Ab; PCR None Died
(4) Puerto Rico (2012) 60/M Agricultural work, resident Diabetes Diabetic ketoacidosis Blood culture; MLST Amoxicillin/cloxacillin (10 d), then oral TMP/SMX (12 weeks) Survived
This study Trinidad and Tobago (2014) 17/M Rainy season, TR CPVT Chronic pneumonia BAL culture; MLST Meropenem (2 weeks), then oral TMP/SMX (8 mo to date) Survived

*Ab, antibody; BAL, bronchoalveolar lavage; CAD, coronary artery disease; CGD, chronic granulomatous disease; CPVT, catecholaminergic polymorphic ventricular tachycardia; CSF, cerebrospinal fluid; G-CSF, granulocyte colony-stimulating factor; IV, intravenous; MLST, multilocus sequence typing; PVD, peripheral vascular disease; Ref., reference; SLE, systemic lupus erythematosus; TMP/SMX, trimethoprim/sulfamethoxazole; TR, travel related; UNK, unknown.
†Cause of death unknown.

Main Article

References
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Page updated: April 17, 2015
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