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Case Report: Fatal Pediatric Melioidosis Despite Optimal Intensive Care

Alice YoungDepartment of Intensive Care, Cairns Hospital, Cairns, Australia;

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Catherine TaconDepartment of Intensive Care, Cairns Hospital, Cairns, Australia;

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Simon SmithDepartment of Medicine, Cairns Hospital, Cairns, Australia;
James Cook University, Cairns, Australia;

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Ben ReevesDepartment of Pediatrics, Cairns Hospital, Cairns, Australia;

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Greg WisemanDepartment of Pediatric Intensive Care, The Townsville Hospital, Townsville, Australia;

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Josh HansonDepartment of Medicine, Cairns Hospital, Cairns, Australia;
Menzies School of Health Research, Darwin, Australia;
The Kirby Institute, Sydney, New South Wales, Australia

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With prompt administration of appropriate antimicrobial therapy and access to modern intensive care support, fatal pediatric melioidosis is very unusual. We describe cases of two children in whom the possibility of melioidosis was recognized relatively early, but who died of the disease, despite receiving optimal supportive care. We discuss the resulting implications for bacterial virulence factors in disease pathogenesis.

Author Notes

Address correspondence to Alice Young, Department of Intensive Care, Cairns Hospital, 165 The Esplanade, Cairns, QLD 4870, Australia. E-mail: alice.young2@health.qld.gov.au

Authors’ addresses: Alice Young, Catherine Tacon, and Ben Reeves, Department of Intensive Care, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia, E-mails: alice.young2@health.qld.gov.au, ctacon@live.com.au, and benjamin.reeves@health.qld.gov.au. Simon Smith, Department of Medicine, Cairns Hospital, Cairns, QLD, Australia and Department of Medicine, James Cook University College of Medicine and Dentistry, Cairns, QLD, Australia, E-mail: simon.smith2@health.qld.gov.au. Greg Wiseman, Department of Pediatric Intensive Care, The Townsville Hospital, Townsville, QLD, Australia, E-mail: greg.wiseman@health.qld.gov.au. Josh Hanson, The Director’s Unit, The Kirby Institute, University of New South Wales, Sydney, NSW Australia and Department of General Medicine, Cairns Hospital, Cairns, QLD, Australia, E-mail: drjoshhanson@gmail.com.

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