Open AccessMelioidosis and idiopathic pulmonary hemosiderosis: a cast‐iron case
Author(s) -
Gerhardy Benjamin,
Simpson Graham
Publication year - 2013
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.25
Subject(s) - melioidosis , burkholderia pseudomallei , medicine , pneumonia , hemosiderosis , virulence , immunology , differential diagnosis , risk factor , population , intensive care medicine , pathology , environmental health , gene , bacteria , biology , biochemistry , genetics
Melioidosis is an infection with clinical importance in northern A ustralia due to the high associated mortality despite appropriate therapy. This report presents a case of acute pulmonary melioidosis on a background remarkable for the absence of typical risk factors for infection, but the presence of a high iron pulmonary microenvironment consequent to idiopathic pulmonary hemosiderosis. In light of recent genetic analysis of B urkholderia pseudomallei , we postulate that the patient inadvertently provided a high‐substrate environment for the iron‐scavenging ability of B . pseudomallei 's siderophore associated virulence factors, giving her a unique major risk factor for infection. This highlights the importance of considering individual patient factors in addition to population‐wide risk factors in the differential diagnosis of a serious illness, and the value of genetic analysis of clinically significant pathogens.