Melioidosis, Northeastern Brazil

Melioidosis is a fatal bacterial infection found in many parts of the tropical belt, particularly in Southeast Asia and northern Australia. Sporadic cases of the disease have been reported previously in Central and South America. In 2003 septicemic melioidosis was diagnosed for the first time in northeastern Brazil by culture of the causal agent, Burkholderia pseudomallei from a 10-year-old boy. That case is believed to be the first culture-confirmed case of melioidosis in Brazil and was part of a small cluster of cases (hereafter termed Brazil outbreak 1). At first, evidence that >1 case of melioidosis had occurred was circumstantial. The diagnosis relied entirely on the phenotypic features of a blood culture isolate from the 10-year-old boy. A more detailed, multidisciplinary investigation obtained further evidence for the case cluster and clarified its likely relationship to infection in the surrounding population