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A review of melioidosis cases imported into Europe.
Eur J Clin Microbiol Infect Dis. 2019 Aug; 38(8):1395-1408.EJ

Abstract

Melioidosis is a tropical bacterial infection, rarely encountered, and poorly known by clinicians. In non-endemic areas, a misdiagnosis can lead to a fatal outcome. This study aims to identify the main characteristics of imported and diagnosed melioidosis cases in Europe to increase clinician's awareness of this diagnosis. A literature review of imported and diagnosed human melioidosis cases in Europe was performed. PubMed and Web of Science search engines were used for retrieving articles from 2000 to November 2018. Seventy-seven cases of imported melioidosis into Europe described in the literature were identified. More than half of the cases were acquired in Thailand (53%) by men (73%). Patients were usually exposed to Burkholderia pseudomallei during a holiday stay (58%) of less than 1 month (23%) and were hospitalized during the month following their return to Europe (58%). Among travelers, melioidosis is less often associated with risk factor (16%), diabetes being the most frequently comorbidity related (19%). The clinical presentation was multifaceted, pneumonia being the most common symptom (52%), followed by cardiovascular form (45%) and skin and soft tissues damages (35%). The diagnosis was obtained by culture (92%), often supplemented by morphological, biochemical, and molecular identification (23%). Misdiagnoses were common (21%). Over half of the patients received a complete and adapted treatment (56%). Mortality is lower for returning traveler (6%). Imported melioidosis cases into Europe have their own characteristics. This possibility should be considered in patients with pneumonia, fever, and/or abscess returning from endemic areas even years after.

Authors+Show Affiliations

Hôpital d'Instruction des Armées Laveran, Marseille, France. sarah.le-tohic@intradef.gouv.fr.Laboratoire de Pharmaco-Chimie Radicalaire, Aix Marseille Univ, CNRS, ICR, Marseille, France, Marseille, France. Assistance Publique-Hôpitaux de Marseille (AP-HM), Oncopharma, Hôpital Nord, Marseille, France.Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge, France.Laboratoire de Pharmaco-Chimie Radicalaire, Aix Marseille Univ, CNRS, ICR, Marseille, France, Marseille, France. Service central de la qualité et de l'information pharmaceutiques (SCQIP), Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.Laboratoire de Pharmaco-Chimie Radicalaire, Aix Marseille Univ, CNRS, ICR, Marseille, France, Marseille, France. Service central de la qualité et de l'information pharmaceutiques (SCQIP), Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30949898

Citation

Le Tohic, Sarah, et al. "A Review of Melioidosis Cases Imported Into Europe." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 38, no. 8, 2019, pp. 1395-1408.
Le Tohic S, Montana M, Koch L, et al. A review of melioidosis cases imported into Europe. Eur J Clin Microbiol Infect Dis. 2019;38(8):1395-1408.
Le Tohic, S., Montana, M., Koch, L., Curti, C., & Vanelle, P. (2019). A review of melioidosis cases imported into Europe. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 38(8), 1395-1408. https://doi.org/10.1007/s10096-019-03548-5
Le Tohic S, et al. A Review of Melioidosis Cases Imported Into Europe. Eur J Clin Microbiol Infect Dis. 2019;38(8):1395-1408. PubMed PMID: 30949898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of melioidosis cases imported into Europe. AU - Le Tohic,Sarah, AU - Montana,Marc, AU - Koch,Lionel, AU - Curti,Christophe, AU - Vanelle,Patrice, Y1 - 2019/04/04/ PY - 2019/02/08/received PY - 2019/03/25/accepted PY - 2019/4/6/pubmed PY - 2019/12/18/medline PY - 2019/4/6/entrez KW - Case reports KW - Melioidosis KW - Pneumonia KW - Travel medicine SP - 1395 EP - 1408 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur J Clin Microbiol Infect Dis VL - 38 IS - 8 N2 - Melioidosis is a tropical bacterial infection, rarely encountered, and poorly known by clinicians. In non-endemic areas, a misdiagnosis can lead to a fatal outcome. This study aims to identify the main characteristics of imported and diagnosed melioidosis cases in Europe to increase clinician's awareness of this diagnosis. A literature review of imported and diagnosed human melioidosis cases in Europe was performed. PubMed and Web of Science search engines were used for retrieving articles from 2000 to November 2018. Seventy-seven cases of imported melioidosis into Europe described in the literature were identified. More than half of the cases were acquired in Thailand (53%) by men (73%). Patients were usually exposed to Burkholderia pseudomallei during a holiday stay (58%) of less than 1 month (23%) and were hospitalized during the month following their return to Europe (58%). Among travelers, melioidosis is less often associated with risk factor (16%), diabetes being the most frequently comorbidity related (19%). The clinical presentation was multifaceted, pneumonia being the most common symptom (52%), followed by cardiovascular form (45%) and skin and soft tissues damages (35%). The diagnosis was obtained by culture (92%), often supplemented by morphological, biochemical, and molecular identification (23%). Misdiagnoses were common (21%). Over half of the patients received a complete and adapted treatment (56%). Mortality is lower for returning traveler (6%). Imported melioidosis cases into Europe have their own characteristics. This possibility should be considered in patients with pneumonia, fever, and/or abscess returning from endemic areas even years after. SN - 1435-4373 UR - https://www.unboundmedicine.com/medline/citation/30949898/A_review_of_melioidosis_cases_imported_into_Europe_ L2 - https://dx.doi.org/10.1007/s10096-019-03548-5 DB - PRIME DP - Unbound Medicine ER -