{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:57:46Z","timestamp":1791385066373,"version":"4.3.3"},"reference-count":11,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Melioidosis is a potentially fatal tropical infection caused by\n                    <jats:italic>Burkholderia pseudomallei<\/jats:italic>\n                    . Although well described in Southeast Asia and northern Australia, its burden in South America remains poorly characterized and likely underestimated. A case of severe disseminated melioidosis in a 35-year-old man with poorly controlled diabetes mellitus residing in the Peruvian Amazon is reported here. The patient presented multifocal pneumonia, bacteremia, and septic shock requiring mechanical ventilation and vasopressor support. During hospitalization, he developed cutaneous microabscesses and septic arthritis of the left knee.\n                    <jats:italic>Burkholderia pseudomallei<\/jats:italic>\n                    was isolated from both blood cultures and synovial fluid, confirming hematogenous dissemination. This case highlights the presence of severe melioidosis in the Peruvian Amazon and underscores the need to consider this pathogen in patients presenting with severe sepsis in tropical regions with high environmental exposure and metabolic risk factors. Strengthening microbiological diagnostic capacity is essential to improve detection of this emerging infection in South America.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0185","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T20:03:10Z","timestamp":1787083390000},"page":"734-737","source":"Crossref","is-referenced-by-count":0,"title":["Severe Disseminated Melioidosis with Pulmonary, Cutaneous, and Osteoarticular Involvement in the Peruvian Amazon"],"prefix":"10.4269","volume":"115","author":[{"given":"Mario","family":"Agramonte-Vilca","sequence":"first","affiliation":[{"name":"Infectious Diseases, Hospital II Pucallpa, Essalud, Ucayali, Per\u00fa;"},{"name":"Professional School of Human Medicine, Universidad San Antonio Abad del Cusco, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefany","family":"Alvis-Sanchez","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Hospital Nacional Edgardo Rebagliati Martins, Essalud, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora Rocio","family":"Mananita-Terrones","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Hospital II Pucallpa, Essalud, Ucayali, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Washington","family":"Ortiz-Uribe","sequence":"additional","affiliation":[{"name":"Microbiology, Hospital II Pucallpa, Essalud, Ucayali, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Mu\u00f1ante-Meneses","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Hospital II Pucallpa, Essalud, Ucayali, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"3","key":"b1","series-title":"Nat Rev Microbiol","first-page":"155","article-title":"Burkholderia pseudomallei and melioidosis","volume":"22","author":"Meumann","year":"2024"},{"issue":"11","key":"b2","series-title":"Pathogens","first-page":"926","article-title":"The Evolving global epidemiology of human melioidosis: A narrative review","volume":"13","author":"Norman","year":"2024"},{"issue":"2","key":"b3","series-title":"Trop Med Infect Dis","first-page":"60","article-title":"Melioidosis in South America","volume":"3","author":"Rolim","year":"2018"},{"key":"b4","series-title":"Se Reporta Caso Confirmado de Melioidosis Por el INS","year":"2016"},{"issue":"12","key":"b5","series-title":"Lancet Infect Dis","first-page":"1737","article-title":"The Darwin Prospective Melioidosis Study: A 30-year prospective, observational investigation","volume":"21","author":"Currie","year":"2021"},{"issue":"2","key":"b6","series-title":"Clin Microbiol Rev","first-page":"e00006","article-title":"Human Melioidosis","volume":"33","author":"Gassiep","year":"2020"},{"issue":"1","key":"b7","series-title":"Open Forum Infect Dis","first-page":"ofae741","article-title":"Osteomyelitis and septic arthritis in the Darwin Prospective Melioidosis Study","volume":"12","author":"Campbell","year":"2025"},{"issue":"6","key":"b8","series-title":"Clin Microbiol Infect","first-page":"827","article-title":"Interpreting Burkholderia pseudomallei disc diffusion susceptibility test results by the EUCAST method","volume":"27","author":"Dance","year":"2021"},{"issue":"5","key":"b9","series-title":"Int J Antimicrob Agents","first-page":"427","article-title":"A comparison of antibiotic susceptibility testing methods for cotrimoxazole with Burkholderia pseudomallei.","volume":"19","author":"Piliouras","year":"2002"},{"issue":"4","key":"b10","series-title":"Open Respir Arch","first-page":"100488","article-title":"Nosocomial and ventilator-associated pneumonia","volume":"7","author":"Cabanillas D\u00edez-Madro\u00f1ero","year":"2025"},{"issue":"10","key":"b11","series-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue","first-page":"1159","article-title":"Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock 2021, interpretation and expectation","volume":"33","author":"Ruiqiang","year":"2021"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/4\/article-p734.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/4\/article-p734.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/4\/article-p734.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:24:42Z","timestamp":1791383082000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/4\/article-p734.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":11,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0185","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}