Kibbler C C, Roberts C M, Ridgway G L, Spiro S G
Department of Clinical Microbiology, University College Hospital, London, UK.
Postgrad Med J. 1991 Aug;67(790):764-6. doi: 10.1136/pgmj.67.790.764.
A 54 year old Bangladeshi man presented with a history and chest X-ray appearances suggestive of pulmonary tuberculosis. Following deterioration 4 weeks later, he required ventilation. Although a blood culture isolate was subsequently found to be Pseudomonas pseudomallei, it was initially misidentified and dismissed as a contaminant. Further cultures demonstrated the organism, but the patient died, despite treatment with ceftazidime. The case illustrates the importance of taking a detailed travel history and having a high index of suspicion in patients from South East Asia and the Indian sub-continent, including Bangladesh, where the disease has not previously been considered endemic.
