S-643 A Case of Melioidosis Presenting as Activation of Latent Infection = S-643 A Case of Melioidosis Presenting as Activation of Latent Infection

다국어 초록 (Multilingual Abstract)

Melioidosis is an infection caused by the facultative intracellular gram-negative bacterium, Burkholderia pseudomallei. It is endemic in Southeast Asia, Northern Australia and China, where Burkholderia pseudomallei is a widely distributed environmental saprophyte in soil and fresh surfaced water. The incubation period following inoculating injury ranges from 1 to 21 days. It presents as a febrile illness, ranging from an acute fulminant septicemia to a chronic debilitating localized infection. Infection with Burkholderia pseudomallei can be latent and subsequently activate, but this type of infection is rare. We report a case of activation of latent focus of Burkholderia pseudomallei infection, presenting as acute pyelonephritis 15 months after coming back from Vietnam and Cambodia. A 76-year-old man with lung cancer who received chemotherapy was hospitalized for fever. The computed tomography showed right acute pyelonephritis. Burkholderia pseudomallei was identified from the urine culture and DNA sequencing of 16S ribosomal RNA with 100% homology. The bacterium was sensitive to imipenem and tetracyclin but resistant to ceftazidime and trimethoprim/sulfamethoxazole on antimicrobial susceptibility test. The patient was treated with carbapenem and improved clinical feature. This is the first report of melioidosis presenting as activation of latent infection in Korea.