A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis
Chenliang Fan,1 Xiaosi Li,1 Baizhi Pi,2 Jiasheng Wu,3 Heping Shen,3 Yumiao Guo,3 Xiaoyan Wu1 1Department of Laboratory Medicine, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China; 2Department of Intensive Care, the Second Affiliated Hospital of Jiaxing...
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Dove Medical Press
2025-07-01
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| author | Fan C Li X Pi B Wu J Shen H Guo Y Wu X |
| author_facet | Fan C Li X Pi B Wu J Shen H Guo Y Wu X |
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| description | Chenliang Fan,1 Xiaosi Li,1 Baizhi Pi,2 Jiasheng Wu,3 Heping Shen,3 Yumiao Guo,3 Xiaoyan Wu1 1Department of Laboratory Medicine, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China; 2Department of Intensive Care, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China; 3Department of Infectious Diseases, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of ChinaCorrespondence: Yumiao Guo, Department of Infectious Diseases, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China, Email guoym0328@163.com Xiaoyan Wu, Department of Laboratory Medicine, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China, Email wxy87751@163.comAbstract: Melioidosis is prevalent in Southeast Asia, acquired via breathing or skin contact with water or soil contaminated by Burkholderia pseudomallei. This article reports a 42-year-old male melioidosis patient without underlying diseases or travel history to epidemic areas, discussing its significance for epidemiology, diagnosis and treatment in non-epidemic areas. The patient’s clinical manifestations, disease progression, previous treatment, admission examination, diagnostic process, treatment and follow-up results were retrospectively analyzed. tNGS, microbial culture and WGS were used for sample and pathogen identification and genetic analysis. The patient had recurrent fever with erythema nodosum on the left lower limb. Misdiagnosed and treated ineffectively in other hospitals, he was diagnosed with melioidosis in the Second Affiliated Hospital of Jiaxing University. The strain was identified as Burkholderia pseudomallei, type ST46. Appropriate antibiotic treatment was selected based on drug sensitivity test results. After 6 months of follow-up, most lesions were absorbed, laboratory indicators normalized and the clinical effect was good. Epidemiological investigations suggested ST46 might be transmitted via non-traditional routes related to the fact that 15 days before the onset of the disease, the patient had purchased live turtles and the soil for raising them online which were sourced from Yunnan, indicating the possibility of geographical transmission. This case enriches understanding of melioidosis’ non-traditional transmission, strain transmission, clinical diagnosis and treatment, highlighting the importance of considering the disease in non-endemic areas’ differential diagnosis and the need for further epidemiological surveillance and research.Keywords: melioidosis, targeted next-generation sequencing, non-endemic areas, non-traditional transmission |
| format | Article |
| id | doaj-art-0f4f477aef7d49d8a3c78bc7f39ba8a7 |
| institution | Matheson Library |
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| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-0f4f477aef7d49d8a3c78bc7f39ba8a72025-07-22T18:12:57ZengDove Medical PressInfection and Drug Resistance1178-69732025-07-01Volume 18Issue 135693577105030A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and DiagnosisFan CLi X0Pi BWu J1Shen H2Guo Y3Wu X4Department of Clinical LaboratoryPulmonary and critical care medicineinfectious diseasesDepartment of Infectious DiseasesDepartment of Clinical LaboratoryChenliang Fan,1 Xiaosi Li,1 Baizhi Pi,2 Jiasheng Wu,3 Heping Shen,3 Yumiao Guo,3 Xiaoyan Wu1 1Department of Laboratory Medicine, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China; 2Department of Intensive Care, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China; 3Department of Infectious Diseases, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of ChinaCorrespondence: Yumiao Guo, Department of Infectious Diseases, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China, Email guoym0328@163.com Xiaoyan Wu, Department of Laboratory Medicine, the Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, People’s Republic of China, Email wxy87751@163.comAbstract: Melioidosis is prevalent in Southeast Asia, acquired via breathing or skin contact with water or soil contaminated by Burkholderia pseudomallei. This article reports a 42-year-old male melioidosis patient without underlying diseases or travel history to epidemic areas, discussing its significance for epidemiology, diagnosis and treatment in non-epidemic areas. The patient’s clinical manifestations, disease progression, previous treatment, admission examination, diagnostic process, treatment and follow-up results were retrospectively analyzed. tNGS, microbial culture and WGS were used for sample and pathogen identification and genetic analysis. The patient had recurrent fever with erythema nodosum on the left lower limb. Misdiagnosed and treated ineffectively in other hospitals, he was diagnosed with melioidosis in the Second Affiliated Hospital of Jiaxing University. The strain was identified as Burkholderia pseudomallei, type ST46. Appropriate antibiotic treatment was selected based on drug sensitivity test results. After 6 months of follow-up, most lesions were absorbed, laboratory indicators normalized and the clinical effect was good. Epidemiological investigations suggested ST46 might be transmitted via non-traditional routes related to the fact that 15 days before the onset of the disease, the patient had purchased live turtles and the soil for raising them online which were sourced from Yunnan, indicating the possibility of geographical transmission. This case enriches understanding of melioidosis’ non-traditional transmission, strain transmission, clinical diagnosis and treatment, highlighting the importance of considering the disease in non-endemic areas’ differential diagnosis and the need for further epidemiological surveillance and research.Keywords: melioidosis, targeted next-generation sequencing, non-endemic areas, non-traditional transmissionhttps://www.dovepress.com/a-case-report-of-unusual-diagnosis-of-melioidosis-in-a-non-traveler-im-peer-reviewed-fulltext-article-IDRMelioidosisTargeted next-generation sequencingNon-endemic areasNon-traditional transmission |
| spellingShingle | Fan C Li X Pi B Wu J Shen H Guo Y Wu X A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis Infection and Drug Resistance Melioidosis Targeted next-generation sequencing Non-endemic areas Non-traditional transmission |
| title | A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis |
| title_full | A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis |
| title_fullStr | A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis |
| title_full_unstemmed | A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis |
| title_short | A Case Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis |
| title_sort | case report of unusual diagnosis of melioidosis in a non traveler implications for transmission and diagnosis |
| topic | Melioidosis Targeted next-generation sequencing Non-endemic areas Non-traditional transmission |
| url | https://www.dovepress.com/a-case-report-of-unusual-diagnosis-of-melioidosis-in-a-non-traveler-im-peer-reviewed-fulltext-article-IDR |
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