Localized Melioidosis in Children in Thailand: Treatment and Long-term Outcome

Melioidosis, an infection caused by Burkholderia pseudomallei, can present as severe septicemia or localized infection. Data on optimum antibiotic treatment regimen for localized melioidosis in children is limited. This is a report on localized melioidosis in children, regarding clinical presentation, treatment and the long-term outcomes. We reviewed 37 cases of localized melioidosis in children treated between 1994 and 2006 and followed up them prospectively until 1 October 2007. The two most common presentations were skin/soft tissue infections and suppurative parotitis. Oral eradication antibiotics after initial parenteral therapy included trimetroprim-sulfamethoxazole (10 patients) and trimetroprim-sulfamethoxazole in combination with doxycycline (four patients). Patients who did not get any parenteral antibiotics for B. pseudomallei were treated with oral trimetroprim-sulfamethoxazole (10 patients) and trimetroprim-sulfamethoxazole in combination with doxycycline (one patient). No adverse effects were reported. We were able to follow-up 32 patients, all recovered except one patient reported a history of possible relapse.