Abstract
This report focuses on a fatality involving severe dengue fever and melioidosis in a 28-year-old truck driver residing in Pacoti in northeastern Brazil. He exhibited long-term respiratory symptoms (48 days) and went through a wide-ranging clinical investigation at three hospitals, after initial clinical diagnoses of pneumonia, visceral leishmaniasis, tuberculosis, and fungal sepsis. After death, Burkholderia pseudomallei was isolated in a culture of ascitic fluid. Dengue virus type 1 was detected by polymerase chain reaction in cerebrospinal fluid (CSF); this infection was the cause of death. This description reinforces the need to consider melioidosis among the reported differential diagnoses of community-acquired infections where both melioidosis and dengue fever are endemic.
Highlights
Melioidosis was first diagnosed in Ceará in 20031,2, and so far, 17 cases have been confirmed
A physical examination revealed nothing abnormal. He was initially diagnosed with pneumonia 7 days after the onset of symptoms, and azithromycin was administered for 5 days (500mg 1x/d) followed by amoxicillin/clavulanate for another 7 days (800/125mg 3x/d)
Burkholderia pseudomallei was isolated in a culture of ascitic fluid
Summary
Melioidosis was first diagnosed in Ceará in 20031,2, and so far, 17 cases have been confirmed. Recent studies indicate that the disease is endemic in northeastern Brazil[3,4]. Dengue fever is endemic in this region, with cases reported since 1986 and widespread outbreaks occurring in 1994, 2003, 2008, and 2011, most significantly affecting the younger portion of the population[5,6].
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