Pulmonary Melioidosis Complicated by Pneumothorax

© 2013 by The Society of Thoracic Surgeons Published by Elsevier Inc tory symptoms improved, and the lung nodules faded after the administration of antibiotics, including meropenem, doxycycline, and trimethoprim-sulfamethoxazole, a right pneumothorax developed. A chest tube was inserted, but the air leak persisted for 1 week (Fig 3). Video-assisted thoracic surgery revealed a 0.5 cm defect over the surface of the right upper lobe, which was repaired by suturing. After the operation, the lung expanded well, and there was no more air leak. The patient remained disease-free after completing 3 months of maintenance treatment with oral doxycycline and the combination of meropenem, doxycycline, and trimethoprim-sulfamethoxazole. Melioidosis is an infectious disease caused by the bacterium B. pseudomallei, which resides in the soil and water of endemic tropical zones [1]. Pneumonia is the most common presentation of melioidosis, and cavitary nodules or abscesses may develop [2]. Pneumothorax is relatively uncommon and makes the course of the disease even more complicated. However, it does not necessarily indicate a poorer outcome. Appropriate antibiotics plus chest tube insertion and video-assisted thoracic surgery as needed may bring forth a good therapeutic response.