Microbiological and immunological studies in a case of human melioidosis diagnosed in Denmark

The first case of melioidosis reported in Denmark was in a 64-year-old man 2 weeks after his return from a 3-week visit to Kenya. The clinical course was characterized by septicaemia and Pseudomonas pseudomallei was isolated from repeated blood cultures, urine and sputum. Transient impairment of cellular immunity was observed. During the convalescence a cell-mediated immune response against the pathogen was detected by the lymphocyte blast transformation test. Two precipitins against P. pseudomallei were detected by crossed immunoelectrophoresis; the most pronounced was directed against the common antigen of P. aeruginosa. The patient was treated with a combination of oxytetracycline, sulfamethoxazole and trimethoprim for one month, followed by sulfamethoxazole and trimethoprim for another month. The clinical response to the treatment was good. The patient had previously had recurrent pulmonary tuberculosis. The relationship of melioidosis to tuberculosis is briefly discussed.