{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:11:51Z","timestamp":1779235911485,"version":"3.51.4"},"reference-count":7,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,1]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>A 26-year-old man, returned to the UK having travelled extensively in Asia. He was referred with a 3-month history of distal leg ulceration following an insect bite while in Thailand. Despite multiple courses of oral antibiotics, he developed two adjacent ulcers. A wound swab isolated an organism identified as <jats:italic>Burkholderia thailandensis<\/jats:italic>. The histology of the skin biopsy was non-specific. A diagnosis of cutaneous melioidosis was made, based on clinical and microbiological grounds. The ulcers re-epithelialised on completion of intravenous ceftazidime followed by 3 months of high dose co-trimoxazole and wound care. Many clinical microbiology laboratories have limited diagnostics for security-related organisms, with the result that <jats:italic>B. pseudomallei<\/jats:italic>, the causative bacterium of melioidosis, may be misidentified. This case highlights the importance of maintaining high levels of clinical suspicion and close microbiological liaison in individuals returning from South-East Asia and northern Australia with such symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2020-241490","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T12:40:32Z","timestamp":1623674432000},"page":"e241490","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Leg ulceration due to cutaneous melioidosis in a returning traveller"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2210-6063","authenticated-orcid":false,"given":"Christiana","family":"Stavrou","sequence":"first","affiliation":[{"name":"Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ophelia","family":"Veraitch","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Morris-Jones","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen L","family":"Walker","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Department of Clinical Research, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"2025082711253730000_14.6.e241490.1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1038\/nmicrobiol.2015.8","article-title":"Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis","volume":"1","author":"Limmathurotsakul","year":"2016","journal-title":"Nat Microbiol"},{"key":"2025082711253730000_14.6.e241490.2","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14167"},{"key":"2025082711253730000_14.6.e241490.3","doi-asserted-by":"publisher","DOI":"10.1086\/590931"},{"key":"2025082711253730000_14.6.e241490.4","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200809040-00002"},{"key":"2025082711253730000_14.6.e241490.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1204699"},{"key":"2025082711253730000_14.6.e241490.6","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01238-14"},{"key":"2025082711253730000_14.6.e241490.7","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.01234"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-241490","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:25:42Z","timestamp":1756319142000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-241490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,14]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2020-241490"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-241490","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}