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Melioidosis in a patient with chronic rhinosinusitis

  • N M Phillips (a1), A Cervin (a2) (a3), J Earnshaw (a2) and H E Sidjabat (a4)



Melioidosis is a serious infection caused by soil-dwelling Gram-negative bacillus Burkholderia pseudomallei. It is most commonly reported in Northern Australia, Southeast and Southern Asia, China, and Taiwan.


A case report and short review of the literature are presented. Presentation, diagnosis including genomic sequencing, and acute and long-term management are discussed.


A 58-year-old female presented with chronic rhinosinusitis secondary to melioidosis. This is the third reported incidence of sinusitis secondary to melioidosis, which occurred in an otherwise well female with no risk factors and no apparent cause of exposure. Treatment involved an acute phase in which meropenem was administered parenterally for two weeks, followed by a prolonged oral course of trimethoprim-sulfamethoxazole for three months, as per recommended guidelines.


In patients presenting with refractory chronic rhinosinusitis, ENT surgeons should consider the presence of unusual causative pathogens such as B pseudomallei, particularly in those with recent travel history to Northern Queensland and/or Southeast Asia.


Corresponding author

Address for correspondence: Dr Nicholas M Phillips, PO Box 1676, Noosa Heads, Queensland, Australia E-mail:


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1 Whitmore, A. An account of a Glanders-like disease occurring in Rangoon. J Hyg (Lond) 1913;13:134.1
2 Yabuuchi, E, Kosako, Y, Oyaizu, H, Yano, I, Hotta, H, Hashimoto, Y et al. Proposal of Burkholderia gen. nov. and transfer of seven species of the genus Pseudomonas homology group II to the new genus, with the type species Burkholderia cepacia (Palleroni and Holmes 1981) comb. nov. Microbiol Immunol 1992;36:1251–75
3 Cheng, AC, Currie, BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 2005;18:383416
4 Chantratita, N, Wuthiekanun, V, Limmathurotsakul, D, Vesaratchavest, M, Thanwisai, A, Amornchai, P et al. Genetic diversity and microevolution of Burkholderia pseudomallei in the environment. PLoS Negl Trop Dis 2008;2:e182
5 Currie, BJ. Melioidosis: evolving concepts in epidemiology, pathogenesis, and treatment. Semin Respir Crit Care Med 2015;36:111–25
6 Currie, BJ, Fisher, DA, Howard, DM, Burrow, JN, Lo, D, Selva-Nayagam, S et al. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 2000;31:981–6
7 Currie, BJ, Ward, L, Cheng, AC. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 2010;4:e900
8 Currie, BJ, Fisher, DA, Anstey, NM, Jacups, SP. Melioidosis: acute and chronic disease, relapse and re-activation. Trans R Soc Trop Med Hyg 2000;94:301–4
9 Sidjabat, HE, Cottrell, K, Cervin, A. Draft genome sequences of Burkholderia pseudomallei and Staphylococcus aureus, isolated from a patient with chronic rhinosinusitis. Genome Announc 2015;3:e0107515
10 Smith, MD, Wuthiekanun, V, Walsh, AL, White, NJ. Susceptibility of Pseudomonas pseudomallei to some newer beta-lactam antibiotics and antibiotic combinations using time-kill studies. J Antimicrob Chemother 1994;33:145–9
11 Piliouras, P, Ulett, GC, Ashhurst-Smith, C, Hirst, RG, Norton, RE. A comparison of antibiotic susceptibility testing methods for cotrimoxazole with Burkholderia pseudomallei. Int J Antimicrob Agents 2002;19:427–9
12 Wong, PK, Ng, PH. Melioidosis presenting with orbital cellulitis. Singapore Med J 1996;37:220–1
13 Lim, RS, Flatman, S, Dahm, MC. Sinonasal melioidosis in a returned traveller presenting with nasal cellulitis and sinusitis. Case Rep Otolaryngol 2013;2013:920352



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