Burkholderia pseudomallei infection presenting with a lung abscess and osteomyelitis in an adult man: A case report

RATIONALE: The frequency of infections caused by Burkholderia pseudomallei is increasing worldwide. Here, we report a case of B pseudomallei infection presenting with a lung abscess and osteomyelitis in an adult man. PATIENT CONCERNS: A 38-year-old man presented with high-grade fever, productive cough, and chronic joint pain of the limbs. Examinations revealed multiple nodules, soft tissue mass shadows, pulmonary cavitation in bilateral lungs, and fluid and soft tissue swelling in bilateral hips. DIAGNOSES: The microbiologic diagnosis based on a positive culture revealed the etiologic agent to be B pseudomallei. INTERVENTIONS: The patient was treated with intravenous ceftazidime and levofloxacin, and out-of-hospital treatment continued with oral cotrimoxazole. OUTCOMES: The patient responded well to the treatment. LESSONS: subsections Because of its increasing incidence, B pseudomallei infection should be highly suspected among employees who work in laboratories and healthcare facilities. Misdiagnosis can lead to treatment failure and high mortality rates, especially among individuals working in laboratories in non-endemic areas; therefore, early and accurate diagnosis of B pseudomallei infection is essential. Adequate antimicrobial treatment and long-term follow-up are imperative to reduce morbidity and mortality.