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Melioidosis and the vacuum-assisted closure device: a rare cause of a discharging neck wound, and a new approach to management

Published online by Cambridge University Press:  11 March 2010

G Garas ,
S Ifeacho ,
R Millard  and
N Tolley
G Garas*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
S Ifeacho
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
R Millard
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
N Tolley
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
*
Address for correspondence: Dr George Garas, Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, Praed Street, London W2 1NY, UK. Fax: +44 207 886 6666 E-mail: [email protected]
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Abstract

Objective:

We report a case of melioidosis presenting as a discharging neck abscess, and we describe the use of a vacuum-assisted closure device in its management.

Method:

We report the case of a 44-year-old, Afro-Caribbean woman with melioidosis. We also present the results of a literature search using the search terms ‘melioidosis’, ‘Burkholderia pseudomallei’ and ‘vacuum-assisted closure device’.

Results:

Microbiological analysis identified the causative organism as being the bacterium Burkholderia pseudomallei, and its antimicrobial sensitivities to imipenem and ciprofloxacin. A vacuum-assisted closure device was used to manage the patient's melioidosis of the neck; we believe this is the first report of such treatment.

Conclusions:

Melioidosis is rare in the UK and western world; however, exposure can occur during travel to endemic areas. We therefore draw attention to this infection as part of the differential diagnosis of a neck abscess. We propose the use of vacuum-assisted closure devices as useful adjuncts to the management of discharging neck wounds.

Keywords

MelioidosisBurkholderia PseudomalleiVacuum Pump
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 1021 - 1024
Copyright
Copyright © JLO (1984) Limited 2010

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