Matthew Chung Yi Koh, Alicia Ang, Jinghao Nicholas Ngiam, David Michael Allen, Brenda Sze Peng Ang
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Abstract
We present a case of a 46-year-old male with disseminated melioidosis. He initially presented with primary bacteremia but eventually developed a recrudescent infection characterized by meningo-rhombencephalitis, as well as pulmonary and splenic abscesses. This was attributed to the emergence of carbapenem resistance, which developed while he was receiving parenteral antibiotic therapy. The patient eventually improved after switching his antibiotics to a combination of ceftazidime and trimethoprim-sulfamethoxazole. The development of carbapenem resistance in Burkholderia pseudomallei during therapy is rare but may be attributed to mutations resulting in the overexpression of efflux pumps. Combination therapy may play a role in such cases by limiting the emergence of antibiotic resistance.
期刊介绍：
The American Journal of Tropical Medicine and Hygiene, established in 1921, is published monthly by the American Society of Tropical Medicine and Hygiene. It is among the top-ranked tropical medicine journals in the world publishing original scientific articles and the latest science covering new research with an emphasis on population, clinical and laboratory science and the application of technology in the fields of tropical medicine, parasitology, immunology, infectious diseases, epidemiology, basic and molecular biology, virology and international medicine.
The Journal publishes unsolicited peer-reviewed manuscripts, review articles, short reports, images in Clinical Tropical Medicine, case studies, reports on the efficacy of new drugs and methods of treatment, prevention and control methodologies,new testing methods and equipment, book reports and Letters to the Editor. Topics range from applied epidemiology in such relevant areas as AIDS to the molecular biology of vaccine development.
The Journal is of interest to epidemiologists, parasitologists, virologists, clinicians, entomologists and public health officials who are concerned with health issues of the tropics, developing nations and emerging infectious diseases. Major granting institutions including philanthropic and governmental institutions active in the public health field, and medical and scientific libraries throughout the world purchase the Journal.
Two or more supplements to the Journal on topics of special interest are published annually. These supplements represent comprehensive and multidisciplinary discussions of issues of concern to tropical disease specialists and health issues of developing countries
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