SHORT REPORT: DISEASE SEVERITY AND OUTCOME OF MELIOIDOSIS IN HIV COINFECTED INDIVIDUALS

Abstract. This study examined whether coinfection with HIV and Burkholderia pseudomallei leads to altered disease severity or outcome associated with melioidosis. Coinfection was detected in only 8 of 524 (1.5%) adults with melioidosis in northeast Thailand. Clinical presentation and acute outcome were similar in HIV-positive and HIV-negative patients. Melioidosis, an infection caused by the bacterium Burkholderia pseudomallei, is a major cause of community-acquired septicemia in northeast Thailand. A wide spectrum of disease presentations is recognized; septicemia is clinically similar to that caused by other major pathogens, whereas subacute and chronic disease may mimic tuberculosis clini-cally.1 There may be prolonged latency between presumed exposure and disease, and recurrence after apparent cure is relatively common. Given the clinical features, the intracel-lular survival of B. pseudomallei, and the lack of protective humoral immunity, it has been suggested that cell-mediated immunity may be important in controlling infection with B. pseudomallei.2,3 However, in contrast with the well-described association between HIV and tuberculosis, the proportion of patients with melioidosis who are coinfected with HIV is low and not significantly different to that in apparently healthy blood donors.4,5 In this case series, we describe the clinical manifestations of patients with melioidosis coinfected with HIV. A retrospective study was performed of patients presentin