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1.
  Smith S , Horne P , Rubenach S , Gair R , Stewart J , Fairhead L , Hanson J , 2021. Increased incidence of melioidosis in Far North Queensland, Queensland, Australia, 1998–2019. Emerg Infect Dis 27: 3119–3123.
-
2.
  Somayaji R , Hantrakun V , Teparrukkul P , Wongsuvan G , Rudd KE , Day NPJ , West TE , Limmathurotsakul D , 2021. Comparative clinical characteristics and outcomes of patients with community acquired bacteremia caused by Escherichia coli, Burkholderia pseudomallei and Staphylococcus aureus: a prospective observational study (Ubon-sepsis). PLoS Negl Trop Dis 15: e0009704.
-
3.
  Sullivan RP , Marshall CS , Anstey NM , Ward L , Currie BJ , 2020. 2020 Review and revision of the 2015 Darwin melioidosis treatment guideline; paradigm drift not shift. PLoS Negl Trop Dis 14: e0008659.
-
4.
  Berger SA , Zonszein J , Villamena P , Mittman N , 1983. Infectious diseases of the thyroid gland. Rev Infect Dis 5: 108–122.
-
5.
  Paes JE , Burman KD , Cohen J , Franklyn J , McHenry CR , Shoham S , Kloos RT , 2010. Acute bacterial suppurative thyroiditis: a clinical review and expert opinion. Thyroid 20: 247–255.
-
6.
  Falhammar H , Wallin G , Calissendorff J , 2019. Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes. BMC Endocr Disord 19: 130.
-
7.
  Yu EH , Ko WC , Chuang YC , Wu TJ , 1998. Suppurative Acinetobacter baumanii thyroiditis with bacteremic pneumonia: case report and review. Clin Infect Dis 27: 1286–1290.
-
8.
  Smith S , Hanson J , Currie BJ , 2018. Melioidosis: an Australian perspective. Trop Med Infect Dis 3: 27.
-
9.
  Gora H , Hasan T , Smith S , Wilson I , Mayo M , Woerle C , Webb JR , Currie BJ , Hanson J , Meumann EM , 2022. Melioidosis of the central nervous system; impact of the bimABm allele on patient presentation and outcome. Clin Infect Dis 2022 Feb 7: ciac111. Available at: https://doi.org/10.1093/cid/ciac111.
-
10.
  Birnie E et al.2019. Melioidosis in travelers: an analysis of Dutch melioidosis registry data 1985–2018. Travel Med Infect Dis 2019 Jul 29: 101461. Available at: https://doi.org/10.1016/j.tmaid.2019.07.017.
-
11.
  Farwell AP , 2000. Infectious thyroiditis. Braverman LE , Utiger RD , eds. Werner & Ingbar’s the Thyroid: A Fundamental and Clinical Text. Philadelphia, PA: Lippincott Williams & Wilkins, 1044–1050.
-
12.
  Pearce EN , Farwell AP , Braverman LE , 2003. Thyroiditis. N Engl J Med 348: 2646–2655.
-
13.
 WorkSafe , 2020. Melioidosis. Available at: https://www.worksafe.qld.gov.au/safety-and-prevention/hazards/hazardous-exposures/biological-hazards/melioidosis. Accessed March 6, 2022.
-
14.
  Stewart JD , Smith S , Binotto E , McBride WJ , Currie BJ , Hanson J , 2017. The epidemiology and clinical features of melioidosis in Far North Queensland: implications for patient management. PLoS Negl Trop Dis 11: e0005411.
-
15.
  Currie BJ et al.2021. The Darwin prospective melioidosis study: a 30-year prospective, observational investigation. Lancet Infect Dis 21: 1737–1746.
-
16.
  Limmathurotsakul D , Chaowagul W , Chierakul W , Stepniewska K , Maharjan B , Wuthiekanun V , White NJ , Day NP , Peacock SJ , 2006. Risk factors for recurrent melioidosis in northeast Thailand. Clin Infect Dis 43: 979–986.
-
17.
  Kozlowska J , Smith S , Roberts J , Pridgeon S , Hanson J , 2018. Prostatic abscess due to Burkholderia pseudomallei: facilitating diagnosis to optimize management. Am J Trop Med Hyg 98: 227–230.
-
18.
  McNamara JF , Harris PNA , Chatfield MD , Paterson DL , 2022. Long term sepsis readmission, mortality and cause of death following Gram negative bloodstream infection: a propensity matched observational linkage study. Int J Infect Dis 114: 34–44.
-
19.
  Hanson J , Smith S , 2019. High rates of premature and potentially preventable death among patients surviving melioidosis in tropical Australia. Am J Trop Med Hyg 101: 328–331.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 18233 | 2564 | 69 |
| Full Text Views | 331 | 8 | 0 |
| PDF Downloads | 148 | 9 | 0 |
Case Report: Disseminated Burkholderia pseudomallei with Acute Suppurative Thyroiditis and Abscess Formation
Julian Harris
Julian Harris
Cairns Hospital, Cairns, Queensland, Australia;
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Simon Smith
Simon Smith
Cairns Hospital, Cairns, Queensland, Australia;
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Soong Zheng Ng
Soong Zheng Ng
Cairns Hospital, Cairns, Queensland, Australia;
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Ashim Sinha
Ashim Sinha
Cairns Hospital, Cairns, Queensland, Australia;
James Cook University, Cairns, Queensland, Australia;
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James Cook University, Cairns, Queensland, Australia;
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Josh Hanson
Josh Hanson
Cairns Hospital, Cairns, Queensland, Australia;
The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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ABSTRACT.
Melioidosis has a highly variable presentation. Almost any organ can be involved, although an antemortem diagnosis of acute suppurative thyroiditis (AST) has not, to our knowledge, been described previously. A 68-year-old Australian male with poorly controlled type 2 diabetes mellitus presented with fever, odynophagia, and thyroid function tests that were consistent with hyperthyroidism. Imaging demonstrated a lung abscess and an enlarged thyroid gland with three nodules. Blood cultures and fine-needle aspiration of the thyroid nodules grew Burkholderia pseudomallei. He received intravenous ceftazidime with concurrent oral trimethoprim/sulfamethoxazole (TMP/SMX) for 4 weeks followed by high-dose oral TMP/SMX for a further 3 months and made a complete recovery. Acute suppurative thyroiditis is an uncommon cause of hyperthyroidism and thyroid aspirates are not commonly sent for bacterial culture. The case highlights the need to consider AST in patients presenting with a hyperthyroid state and disseminated infection. It also demonstrates that in a case of disseminated melioidosis any symptom may be a clue to underlying metastatic infection.
Author Notes
Authors’ addresses: Julian Harris, Simon Smith, and Soong Zheng Ng, Cairns Hospital, Cairns, Queensland, Australia, E-mails: Julian.Harris@health.qld.gov.au, Simon.Smith2@health.qld.gov.au, and Soong.Ng@health.qld.gov.au. Ashim Sinha, Cairns Hospital, Cairns, Queensland, Australia, and James Cook University, Cairns, Queensland, Australia, E-mail: Ashim.Sinha@health.qld.gov.au. Josh Hanson, Cairns Hospital, Cairns, Queensland, Australia, and The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia, E-mail: jhanson@kirby.unsw.edu.au.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
  Smith S , Horne P , Rubenach S , Gair R , Stewart J , Fairhead L , Hanson J , 2021. Increased incidence of melioidosis in Far North Queensland, Queensland, Australia, 1998–2019. Emerg Infect Dis 27: 3119–3123.
-
2.
  Somayaji R , Hantrakun V , Teparrukkul P , Wongsuvan G , Rudd KE , Day NPJ , West TE , Limmathurotsakul D , 2021. Comparative clinical characteristics and outcomes of patients with community acquired bacteremia caused by Escherichia coli, Burkholderia pseudomallei and Staphylococcus aureus: a prospective observational study (Ubon-sepsis). PLoS Negl Trop Dis 15: e0009704.
-
3.
  Sullivan RP , Marshall CS , Anstey NM , Ward L , Currie BJ , 2020. 2020 Review and revision of the 2015 Darwin melioidosis treatment guideline; paradigm drift not shift. PLoS Negl Trop Dis 14: e0008659.
-
4.
  Berger SA , Zonszein J , Villamena P , Mittman N , 1983. Infectious diseases of the thyroid gland. Rev Infect Dis 5: 108–122.
-
5.
  Paes JE , Burman KD , Cohen J , Franklyn J , McHenry CR , Shoham S , Kloos RT , 2010. Acute bacterial suppurative thyroiditis: a clinical review and expert opinion. Thyroid 20: 247–255.
-
6.
  Falhammar H , Wallin G , Calissendorff J , 2019. Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes. BMC Endocr Disord 19: 130.
-
7.
  Yu EH , Ko WC , Chuang YC , Wu TJ , 1998. Suppurative Acinetobacter baumanii thyroiditis with bacteremic pneumonia: case report and review. Clin Infect Dis 27: 1286–1290.
-
8.
  Smith S , Hanson J , Currie BJ , 2018. Melioidosis: an Australian perspective. Trop Med Infect Dis 3: 27.
-
9.
  Gora H , Hasan T , Smith S , Wilson I , Mayo M , Woerle C , Webb JR , Currie BJ , Hanson J , Meumann EM , 2022. Melioidosis of the central nervous system; impact of the bimABm allele on patient presentation and outcome. Clin Infect Dis 2022 Feb 7: ciac111. Available at: https://doi.org/10.1093/cid/ciac111.
-
10.
  Birnie E et al.2019. Melioidosis in travelers: an analysis of Dutch melioidosis registry data 1985–2018. Travel Med Infect Dis 2019 Jul 29: 101461. Available at: https://doi.org/10.1016/j.tmaid.2019.07.017.
-
11.
  Farwell AP , 2000. Infectious thyroiditis. Braverman LE , Utiger RD , eds. Werner & Ingbar’s the Thyroid: A Fundamental and Clinical Text. Philadelphia, PA: Lippincott Williams & Wilkins, 1044–1050.
-
12.
  Pearce EN , Farwell AP , Braverman LE , 2003. Thyroiditis. N Engl J Med 348: 2646–2655.
-
13.
 WorkSafe , 2020. Melioidosis. Available at: https://www.worksafe.qld.gov.au/safety-and-prevention/hazards/hazardous-exposures/biological-hazards/melioidosis. Accessed March 6, 2022.
-
14.
  Stewart JD , Smith S , Binotto E , McBride WJ , Currie BJ , Hanson J , 2017. The epidemiology and clinical features of melioidosis in Far North Queensland: implications for patient management. PLoS Negl Trop Dis 11: e0005411.
-
15.
  Currie BJ et al.2021. The Darwin prospective melioidosis study: a 30-year prospective, observational investigation. Lancet Infect Dis 21: 1737–1746.
-
16.
  Limmathurotsakul D , Chaowagul W , Chierakul W , Stepniewska K , Maharjan B , Wuthiekanun V , White NJ , Day NP , Peacock SJ , 2006. Risk factors for recurrent melioidosis in northeast Thailand. Clin Infect Dis 43: 979–986.
-
17.
  Kozlowska J , Smith S , Roberts J , Pridgeon S , Hanson J , 2018. Prostatic abscess due to Burkholderia pseudomallei: facilitating diagnosis to optimize management. Am J Trop Med Hyg 98: 227–230.
-
18.
  McNamara JF , Harris PNA , Chatfield MD , Paterson DL , 2022. Long term sepsis readmission, mortality and cause of death following Gram negative bloodstream infection: a propensity matched observational linkage study. Int J Infect Dis 114: 34–44.
-
19.
  Hanson J , Smith S , 2019. High rates of premature and potentially preventable death among patients surviving melioidosis in tropical Australia. Am J Trop Med Hyg 101: 328–331.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 18233 | 2564 | 69 |
| Full Text Views | 331 | 8 | 0 |
| PDF Downloads | 148 | 9 | 0 |