Of onions and men: Report of cavitary community acquired pneumonia due to <em>Burkholderia cepacia</em> complex in an immunocompetent patient and review of the literature

Monaldi Arch Chest Dis. 2020 Sep 22;90(4). doi: 10.4081/monaldi.2020.1484.

Abstract

Burkholderia cepacia complex consists of highly antibiotic resistant gram negative bacilli that are plant symbionts and also potential agents of human infection. This bacterial family's claim to fame in clinical medicine is as the scourge of cystic fibrosis patients, in whom it is a notorious respiratory pathogen. Outside of cystic fibrosis, it rarely comes to mind as an etiology of community acquired pneumonia with or without lung cavitation in immunocompetent hosts. We describe a case of an otherwise healthy, community-dwelling man who presented with subacute cavitary lung disease, the causative organism of which turned out to be Burkholderia cepacia complex. Our report is accompanied by a review of the literature, which identified an additional eleven cases in the same category. We analyze all of the available cases for the emergence of any identifiable patterns or peculiarities.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aftercare
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Bronchoalveolar Lavage / methods
  • Burkholderia Infections / complications
  • Burkholderia Infections / immunology
  • Burkholderia Infections / microbiology
  • Burkholderia cepacia complex / genetics
  • Burkholderia cepacia complex / isolation & purification*
  • Burkholderia cepacia complex / pathogenicity
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / microbiology*
  • Diagnosis, Differential
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods
  • Female
  • Humans
  • Immunocompetence / immunology
  • Male
  • Middle Aged
  • Onions / microbiology*
  • Plant Diseases / microbiology*
  • Pneumonia / diagnosis
  • Pneumonia / drug therapy
  • Pneumonia / microbiology*
  • Pneumonia / pathology
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination