Cervical abscesses due to co-infection with Burkholderia pseudomallei, Salmonella enterica serovar Stanley and Mycobacterium tuberculosis in a patient with diabetes mellitus

BMC Infectious Diseases

Claire M Italiano²  Kein Seong Mun¹  Sasheela Ponnampalavanar²  Helmi Sulaiman² 

[1] Division of Anatomical Pathology, Department of Pathology, University Malaya Medical Centre, Kuala Lumpur, Malaysia;Division of Infectious Diseases, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia

关键词: Diabetes;    Salmonella stanley;    Tuberculosis;    Melioidosis;   

Others  :  1145443
DOI  :  10.1186/1471-2334-13-527

 received in 2013-07-09, accepted in 2013-11-01,  发布年份 2013

【 摘 要 】

Background

Infections due to Mycobacterium tuberculosis, Burkholderia pseudomallei and non-typhoidal Salmonella cause significant morbidity and mortality throughout the world. These intracellular pathogens share some common predisposing factors and clinical features. Co-infection with two of these organisms has been reported previously but, to our knowledge, this is the first time that infection with all three has been reported in one person.

Case presentation

In September 2010, a 58-year-old diabetic Malaysian male presented with fever and a fluctuant mass on the right side of his neck. B. pseudomallei was isolated from an aspirate of this lesion and there was radiological evidence of disseminated infection in the liver and spleen. The recurrence of clinical symptoms over ensuing months prompted further aspiration and biopsy of a cervical abscess and underlying lymph nodes. Salmonella enterica serovar Stanley and then M. tuberculosis were identified from these specimens by culture and molecular methods. The patient responded to targeted medical management of each of these infections.

Conclusion

In endemic settings, a high index of suspicion and adequate tissue sampling are imperative in identifying these pathogenic organisms. Diabetes was identified as a predisposing factor in this case while our understanding of other potential risk factors is evolving.

【 授权许可】

   
2013 Sulaiman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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