Wilson J W, Ashdown L R, Richards M J, Sutherland A D, Cade J F
Med J Aust. 1987 Jul 20;147(2):95-6. doi: 10.5694/j.1326-5377.1987.tb133271.x.
Previous reports of cases of melioidosis that were seen in nonendemic areas of Australia describe recrudescences of latent infection. We describe the case of a patient who presented in the cooler climate of Melbourne with a probable primary, subacute pulmonary infection with Pseudomonas pseudomallei. This case illustrates several points that bear consideration in the management of atypical pneumonia and, more specifically, pulmonary melioidosis. Historical and occupational clues are easily missed or unrecognized, while a persistent growth of gentamicin-resistant Pseudomonas species should arouse suspicion. Septicaemic melioidosis carries a poor prognosis, and treatment should be early and aggressive; use of the newer, third-generation cephalosporin agents should be considered. Given active support in a well-equipped intensive care unit, together with appropriate antibiotic therapy, patients may eventually be cured of this infection, but a high mortality rate is still encountered.
先前在澳大利亚非流行地区出现的类鼻疽病例报告描述了潜伏感染的复发情况。我们描述了一名患者的病例，该患者在墨尔本较凉爽的气候中出现了可能由类鼻疽杆菌引起的原发性亚急性肺部感染。该病例说明了在非典型肺炎管理中，更具体地说是在肺类鼻疽管理中需要考虑的几个要点。病史和职业线索很容易被忽视或未被识别，而对庆大霉素耐药的假单胞菌属细菌持续生长应引起怀疑。败血症型类鼻疽预后不良，治疗应尽早且积极；应考虑使用更新的第三代头孢菌素类药物。在设备完善的重症监护病房给予积极支持，并配合适当的抗生素治疗，患者最终可能治愈这种感染，但仍会遇到高死亡率。
