Abscess caused by a rare pathogen - Burkholderia gladioli

Introduction Burkholderia gladioli - is known as a phytopathogenic bacterium but has also been identified to cause human infections in multiple cases within the last few years. Clinical symptoms varied. Most cases were associated with cystic fibrosis, lung transplantation or chronic granulomatous disease.

Case Report A 78 year old female patient presented with subfebrile temperatures and a progressive rightsided odynodysphagia lasting since two days. Relevant secondary diagnoses were COPD and rheumatoid arthritis. Upon examination a reddened protrusion of the right lateral wall of the oropharynx reaching from the lower part of the tonsil to the epiglottic vallecula could be found. Furthermore an oedematous swelling of the lingual surface of the epiglottis was detected. The laboratory tests showed elevated markers of inflammation. As primary treatment an intraoral incision and drainage of the parapharygeal abscess with production of pus was performed. After an inadequate clinical recovery and further diagnostics via MRI an abscess-tonsillectomy was completed. There was no trace of fluid or pus within the wound. The intraoperative swap showed growth of Bukholderia gladioli. Treatment with antibiotics according to resistrogram finally lead to a clinical and paraclinical remission.

Discussion Although rarely foundin in human infections, the bacterium can manifest itself in the form of sepsis, pneumonia, abscesses or lymphadenitis. Most of these patients are immunodeficient, as our patient was. The therapy with aminoglycoside antibiotics often leads, as in our case, to a recovery from the infection. The bacterial strain of Burkholderia with its for humans partially very pathogenic subgroups is a possible agent for biological weapons.

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Publication History

Article published online:
10 June 2020