RESUMEN
Melioidosis is an important disease in Asia and Australia. It is very rare in Venezuela. We describe the case of a 50-year-old diabetic patient with several episodes of right tibial osteomyelitis, left shoulder arthritis, sternal osteomyelitis, right parietal osteomyelitis, and subperiosteal abscess, followed by septic arthritis of the right knee. In all cases Gram stain smear showed Gram-negative bacilli. Culture yielded Burkholderia pseudomallei, susceptible to third- and fourth-generation cephalosporins, ciprofloxacin and aztreonam, and resistant to aminoglycosides. He developed sepsis syndrome. Blood cultures and culture of abscess and joint fluids also revealed B. pseudomallei. The patient was treated with ceftazidime and ciprofloxacin, then cefepime and trimethoprim-sulfamethoxazole. He was discharged with suppressive therapy consisting of oral doxycycline and trimethoprim-sulfamethoxazole, and follow-up has continued to date. At this time he remains asymptomatic. Melioidosis is an extremely rare disease in our country. To our knowledge, this is only the second case reported in Venezuela.
Asunto(s)
Bacteriemia/diagnóstico , Burkholderia pseudomallei/aislamiento & purificación , Melioidosis/diagnóstico , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Cefepima , Ceftazidima/uso terapéutico , Cefalosporinas/uso terapéutico , Ciprofloxacina/uso terapéutico , Quimioterapia Combinada , Humanos , Masculino , Melioidosis/tratamiento farmacológico , Melioidosis/microbiología , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
The aim of this study was to characterize the virulence properties and the antimicrobial resistance of Vibrio cholerae isolates from a coastal area of the Caribbean Sea. Three V. cholerae isolates were obtained from seawater and plankton using the HP selective medium for Helicobacter pylori. These V. cholerae isolates belonged to the non-O1, non-O139 serogroups and they did not have cholera toxin genes. They were resistant to penicillins and some cephalosporins and were sensitive to netilmicin, tetracyclines, sulfamethoxazole-trimethoprim and quinolones. This is the first study that provides biochemical and molecular evidence of non-O1, non-O139 V. cholerae isolates, non-toxigenic, carrying antibiotic resistance in seawater and plankton from a coastal area of the Caribbean Sea.