P-088: MELIOIDOSIS AND SICKLE CELL DISEASE: DESCRIPTION OF A RARE ASSOCIATION

Abstract

Purpose: Melioidosis and its germ Burkholderia pseudomallei are increasingly reported on the African continent and particularly in Central Africa. It is called “Great Mimicker” because it produces a wide range of clinical characteristics that would be found in patients living with major sickle cell syndrome. Few cases have been reported in Africa. But In DRC no cases have been previously described in SCD patients. Materials and methods: We describe here 3 clinical cases presenting this very rare association between melioidosis and sickle cell disease. Results: Three homozygous SS children residing in Lubumbashi in the Democratic Republic of Congo were concerned. One patient presented with sepsis as a clinical form of the disease. All 3 had presented a pulmonary form, 2 pneumonia and 1 pleuropneumonia. The 1rst one patient with spesis was treated specifically with infusion ceftazidime for 21 days followed by oral cotrimoxazole for 2 months after the diagnosis of melioidosis. Regular clinical improvement was observed with treatment although fever did not decrease until the 17th day after admission. The patient was discharged on the 22nd day. The patient was seen again in consultation three months after his discharge from the hospital. He was asymptomatic and the clinical examination was unremarkable. For the other two cases, diagnosis was confirmed in postmortem. Globally, the death rate was 66.67%. Conclusion: These cases are, to our knowledge, the first cases of melioidosis reported in sickle cell patients. This association requires further researches to establish whether, like beta-thalassemia major, sickle cell anemia can be considered as a risk factor for melioidosis. A screening of cases of melioidosis in SCD cohorts should allow a best comprehension of a such association. The authors do not declare any conflict of interest