Development of ceftazidime resistance in Burkhoderia pseudomallei in a patient experiencing melioidosis with mediastinal lymphadenitis.

Dear Editor Melioidosis caused by Burkholderia pseudomallei is endemic to Southeast Asia and Northern Australia.1,2 Melioidosis was nicknamed the “greater mimicker” because of its diverse clinical manifestations. We report a case of melioidosis manifested as mediastinal lymphadenitis and ceftazidime-susceptible B. pseudomallei bacteremia. After treatment with ceftazidime, the B. pseudomallei that subsequently grew from the patient’s lymphatic tissue was found to be resistant to ceftazidime. The patient was successfully treated with imipenem and surgical intervention. Literature was additionally reviewed.