Burkholderia cepacia infection in a non-cystic fibrosis patient: an arcane presentation

Burkholderia cepaciais an aerobic, Gram-negative bacillus, which exhibits innate resistance to multiple antibiotics and disinfectants. Although it is a chronic colonizer of the respiratory tract, it may rarely present with fatal necrotizing pneumonia-like features in immunosuppressed individuals, as those with chronic granulomatous disease, or patients with significant pulmonary compromise, like cystic fibrosis. Case Presentation A 76-year-old male presented with complaints of breathlessness, cough with mucoid expectoration and fever for 3 days. He had a history of coronary artery disease, chronic obstructive pulmonary disease (COPD), diabetes mellitus and hypertension, under treatment. Pulmonary function tests were suggestive of very severe obstruction (FEV1/FVC was 55 %). So, clinical diagnosis of acute exacerbation of COPD was established. Sputum culture grewB. cepacia . The patient was treated with ceftazidime and meropenem along with inhalational bronchodilators and steroids, and showed symptomatic response to therapy. Conclusion There is paucity of the literature describingB. cepaciaas a potential cause for acute exacerbations in relatively common clinical conditions, such as COPD. This case report highlights the speculation of this rare possibility, thereby alerting a clinician dealing with such cases.