Abstract
Diagnosis of Burkholderia pseudomallei pneumonia in children is challenging. We investigated the utility of nasopharyngeal swabs taken from 194 paediatric patients on admission with radiologically proven pneumonia. Melioidosis was proven in 0.5% of samples tested and only in a third of those known to be bacteraemic with B. pseudomallei. It appears unlikely that culture of nasopharyngeal secretions is helpful to confirm B. pseudomallei pneumonia in paediatric patients.
Highlights
Burkholderia pseudomallei is a Gram-negative saprophyte found in the wet soils of many tropical countries [1]
We investigated the utility of nasopharyngeal swabs taken from 194 paediatric patients on admission with radiologically proven pneumonia
Burkholderia pseudomallei was isolated in only 1 of the 194 (0.5%) NP swab samples tested
Summary
Burkholderia pseudomallei is a Gram-negative saprophyte found in the wet soils of many tropical countries [1]. The infection is typified by abscess formation and can lead to a variety of clinical presentations in children, ranging from suppurative parotitis to fulminant sepsis. The lungs are the most common site of infection with B. pseudomallei [2]. Pneumonia accounted for 29% of presentations in a recent review of 24 years of paediatric melioidosis from Northern Australia [3] and 8% of the first 39 cases identified at Angkor Hospital for Children (AHC), Cambodia [4]. In the paediatric population, obtaining sputum for culture is often not possible. Nasopharyngeal (NP) swabs have been used as diagnostic specimens in pneumonia cases. This approach has proven successful for detection of viral pathogens, for example respiratory syncytial
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