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Recrudescent Melioidosis Associated With Diabetic Ketoacidosis

Alva E. Jackson, MC, USA; William L. Moore Jr., MC, USA; Jay P. Sanford, MD
Arch Intern Med. 1972;130(2):268-271. doi:10.1001/archinte.1972.03650020090016.
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Melioidosis has emerged from being a rare exotic infection to one of considerable importance in the United States during the past decade because of the large number of military and civilian personnel exposed to the causative agent, Pseudomonas pseudomallei, which is ubiquitous in the soil and water of Southeast Asia.1-5 While the total number of recognized cases of overt melioidosis has been relatively small, deficiencies in our knowledge of its natural history preclude the conclusion that with our ultimate withdrawal from Indochina, melioidosis with its exacting requirements for diagnosis and appropriate management can be eclipsed from major consideration by physicians in the United States. The case to be presented here is particularly noteworthy in that it illustrates the potential hazard for delayed reactivation of latent disease. This case, as well as additional scattered reports, poses multiple questions: What is the likelihood that an individual with inapparent melioidosis might activate


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