The Turkish Journal of Pediatrics
2012 , Vol 54 , Num 6
Soft Tissue Infection Caused by Burkholderia cepacia in a Child with Polyarteritis Nodosa
Departments of 1Pediatric Infectious Diseases, 2Pediatric Intensive Care and 3Pediatric Rheumatologic Diseases, Ege
University Faculty of Medicine, İzmir, Turkey. E-mail: basakyildiz@gmail.com
Burkholderia cepacia belongs to a family of Burkholderia species previously
described as Pseudomonas cepacia, especially in patients suffering from cystic
fibrosis. There are also many studies about this agent in the last decade
due to their life-threatening infections and ability to invade mucosal and
cellular surfaces. Here, we report a case of soft tissue infection caused by B.
cepacia in a child with an underlying condition of polyarteritis nodosa. Her
complaints started at two months of age and she was on cyclosporine therapy.
She was treated several times because of soft tissue infections especially in
her extremities. The most common causative agents were Pseudomonas spp.
and Escherichia coli, but recently, another soft tissue infection accompanied by
fever and signs of sepsis had developed. All blood, urine and tissue (debrided
from the necrotic area) specimens were incubated. Empirical antibiotherapy
with clindamycin was started and cyclosporine therapy was discontinued. B.
cepacia was grown in the tissue specimen culture and was only susceptible
to carbapenems. Meropenem therapy was administered throughout 14 days
with a daily dosage of 60 mg/kg, and she was treated successfully at least
in this attack of soft tissue infection, which caused more severe sepsis and
tissue damage than the previous infections with other agents.
Keywords :
Burkholderia cepacia, deep tissue infection, polyarteritis nodosa,
antimicrobials.