Whitmore"(TM)s disease in a diabetic patient

Abstract

Burkholderia pseudomallei is a pathogen found in tropical climates. Clinically, it manifests with a wide variety of nonspecific symptoms. We present the case of a 64-year-old male patient with a history of controlled type 2 diabetes mellitus, stage IIIB chronic kidney disease and tuberculosis treated in 2015, who had a prolonged febrile syndrome and chest pain with ischemic electrocardiographic changes. He underwent arteriography which revealed multivessel coronary disease with an indication for open surgical treatment. On his presurgical laboratory tests a chest tomography showed an upper right mediastinal mass, and therefore his procedure was postponed. The mass was studied on an outpatient basis with a negative biopsy for malignancy and microorganisms. He subsequently developed asthenia and adynamia over four months, at which time B. pseudomallei was isolated in blood cultures. He was successfully treated with a carbapenem for 15 days and is now receiving maintenance treatment with no complications