Melioidosis of the Female Genitourinary Tract

Kelly Baker Department of Medicine, Cairns Hospital, Cairns, Australia;

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Simon Smith Department of Medicine, Cairns Hospital, Cairns, Australia;

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James Stewart Department of Medicine, Cairns Hospital, Cairns, Australia;

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Grant Withey Department of Radiology, Cairns Hospital, Cairns, Australia;

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Madeleine Bain Department of Surgery, Cairns Hospital, Cairns, Australia;

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Simon Pridgeon Department of Surgery, Cairns Hospital, Cairns, Australia;

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Josh Hanson Department of Medicine, Cairns Hospital, Cairns, Australia;
The Kirby Institute, University of New South Wales, Sydney, Australia

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ABSTRACT.

Prostatic abscess is a common manifestation of melioidosis in men, but the characteristics of female genitourinary melioidosis are incompletely defined. There were 453 cases of melioidosis in Far North Queensland, tropical Australia, between January 1998 and April 2023; genitourinary involvement was less common in women than in men (13/140 [9%] versus 76/313 [24%], odds ratio [95% confidence interval]: 0.32 [0.17–0.60], P = 0.0004). In 11 of these 13 (85%) women, other organs were also affected. The two women with disease involving only the genitourinary tract had underlying anatomical abnormalities: one had an ovarian malignancy, the only case to involve the female reproductive system in the cohort, while the other had a urethral diverticulum. In 3 of 13 (23%) women, genitourinary involvement was identified only with computed tomography, emphasizing the importance of early imaging of patients with melioidosis to identify unexpected foci of disease and to inform the optimal duration of antibiotic therapy.

Author Notes

Authors’ addresses: Kelly Baker, Simon Smith, and James Stewart, Department of Medicine, Cairns Hospital, Cairns, Australia, E-mails: kelly.baker@health.qld.gov.au, simon.smith2@health.qld.gov.au, and james.stewart7@health.qld.gov.au. Grant Withey, Department of Radiology, Cairns Hospital, Cairns, Australia, E-mail: grant.withey@health.qld.gov.au. Madeleine Bain and Simon Pridgeon, Department of Surgery, Cairns Hospital, Cairns, Australia, E-mails: madeleine.bain@health.qld.gov.au and simon.pridgeon@health.qld.gov.au. Josh Hanson, Department of Medicine, Cairns Hospital, Cairns, Australia, and The Kirby Institute, University of New South Wales, Sydney, Australia, E-mail: jhanson@kirby.unsw.edu.au.

Address correspondence to Josh Hanson, Kirby Institute, Wallace Wurth Building, University of New South Wales, High St., Kensington, NSW 2052, Australia. E-mail: jhanson@kirby.unsw.edu.au
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