Severe community-acquired pneumonia and sepsis caused by Burkholderia pseudomallei associated with flooding in Puerto Rico

Burkholderia pseudomallei (melioidosis) is usually found in endemic areas of Southeast Asia and Northern Australia. However, a few cases of confirmed melioidosis indigenous to Puerto Rico and the Americas have been reported previously. We describe the occurrence of a B. pseudomallei infection in a female with insulin-dependent diabetes mellitus exposed to flood waters in Puerto Rico. We conclude that B. pseudomallei should be considered a potential pathogen in high-risk patients with severe community-acquired pneumonia and sepsis in Puerto Rico especially in individuals exposed to flood waters during rainy seasons. A more thorough epidemiologic and microbiologic surveillance with environmental sampling may be warranted in the island