Four Fatal Cases of Melioidosis in U. S. Soldiers in Vietnam

Abstract
Summary The bacteriologic and pathological characteristics of four fatal cases of melioidosis are reported. Pseudomonas pseudomallei was cultured from the following specimens: 1) ante mortem—sputum, skin lesions, blood, synovial fluid, and bone marrow; 2) post mortem—lung, meninges, heart blood, spinal fluid, pleural cavity, and skin lesions. Eosin-methylene blue agar was found to be the medium of choice for primary isolation. All isolates of the organism were homogeneous in their biochemical and serologic characteristics as were their sensitivities to a variety of antibiotics and a sulfa drug. Post-mortem examination in Case 4 showed gross and microscopic lesions in the lungs, skin, and kidneys. Microscopic lesions were also found in the liver and spleen. In Cases 1, 2, and 3 there were gross lesions in the lungs, skin, kidneys, liver, spleen, subcutaneous tissue, lymph nodes, and meninges. These were confirmed microscopically.

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