PT  - JOURNAL ARTICLE
AU  - Christiana Stavrou
AU  - Ophelia Veraitch
AU  - Stephen Morris-Jones
AU  - Stephen L Walker
TI  - Leg ulceration due to cutaneous melioidosis in a returning traveller
AID  - 10.1136/bcr-2020-241490
DP  - 2021 Jun 01
TA  - BMJ Case Reports
PG  - e241490
VI  - 14
IP  - 6
4099  - http://casereports.bmj.com/content/14/6/e241490.short
4100  - http://casereports.bmj.com/content/14/6/e241490.full
SO  - BMJ Case Reports2021 Jun 01; 14
AB  - A 26-year-old man, returned to the UK having travelled extensively in Asia. He was referred with a 3-month history of distal leg ulceration following an insect bite while in Thailand. Despite multiple courses of oral antibiotics, he developed two adjacent ulcers. A wound swab isolated an organism identified as Burkholderia thailandensis. The histology of the skin biopsy was non-specific. A diagnosis of cutaneous melioidosis was made, based on clinical and microbiological grounds. The ulcers re-epithelialised on completion of intravenous ceftazidime followed by 3 months of high dose co-trimoxazole and wound care. Many clinical microbiology laboratories have limited diagnostics for security-related organisms, with the result that B. pseudomallei, the causative bacterium of melioidosis, may be misidentified. This case highlights the importance of maintaining high levels of clinical suspicion and close microbiological liaison in individuals returning from South-East Asia and northern Australia with such symptoms.