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

J Laryngol Otol

Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK.

Published: September 2010

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.

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http://dx.doi.org/10.1017/S0022215110000381DOI Listing

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