Naha Kushal, Shastry Barkur Ananthakrishna, Saravu Kavitha
Department of Medicine, Kasturba Hospital, Manipal-576 104, Karnataka, India.
Asian Pac J Trop Med. 2014 Mar;7(3):250-2. doi: 10.1016/S1995-7645(14)60031-6.
A 19-year-old Asian Indian female presented with productive cough since the past one month and low grade fever since the past two weeks. She was diagnosed with pulmonary tuberculosis and treated with antitubercular drugs. Subsequently, delayed cultures of bronchoalveolar lavage fluid grew Burkholderia pseudomallei (B. pseudomallei). On follow up the patient reported significant subjective improvement and ESR progressively returned to normal. In summary, this case report raises two distinct and equally intriguing roles for B. pseudomallei, i.e. respiratory colonization and spontaneously resolving pulmonary infection. The pathogenic potential of B. pseudomallei, the etiologic agent of melioidosis, is well known. Confirmation of either colonization or spontaneous resolution, would potentially spare many patients unnecessary and expensive therapy with broad-spectrum antibiotics, and contribute to more rational usage of antibiotics, especially in co-infection with Mycobacterium tuberculosis and B. pseudomallei-two bacterial diseases with closely similar clinical, radiologic and histopathologic features.
一名19岁的亚洲印度女性，自过去一个月以来出现咳痰，自过去两周以来出现低热。她被诊断为肺结核并接受了抗结核药物治疗。随后，支气管肺泡灌洗液的延迟培养培养出了类鼻疽伯克霍尔德菌（B. pseudomallei）。随访时，患者报告主观症状有显著改善，血沉逐渐恢复正常。总之，本病例报告提出了类鼻疽伯克霍尔德菌的两种不同但同样有趣的情况，即呼吸道定植和自发缓解的肺部感染。类鼻疽伯克霍尔德菌是类鼻疽病的病原体，其致病潜力是众所周知的。确定是定植还是自发缓解，可能会使许多患者免于使用不必要且昂贵的广谱抗生素治疗，并有助于更合理地使用抗生素，特别是在与结核分枝杆菌和类鼻疽伯克霍尔德菌合并感染时——这两种细菌性疾病具有非常相似的临床、放射学和组织病理学特征。
