meropenem and Mediastinal-Diseases

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is routinely performed for diagnostic evaluation of mediastinal lymphadenopathy due to various etiologies with excellent sensitivity and specificity. Melioidosis can have atypical features like isolated mediastinal lymphadenopathy mimicking as tuberculosis or lymphoma. Differentiation of such atypical melioidosis presentation become difficult due to similar clinical, radiological and even similar EBUS lymph node characteristics. Role of EBUS TBNA in diagnosing melioidosis is under investigated and sparsely reported. We describe two cases of melioidosis diagnosed by point of care rapid lateral flow immunoassay antigen testing and culture of EBUS-TBNA samples from necrotic mediastinal lymph nodes.

Topics: Administration, Intravenous; Administration, Oral; Aged; Anti-Bacterial Agents; Burkholderia pseudomallei; Doxycycline; Drug Therapy, Combination; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Immunoassay; Lymph Nodes; Lymphadenopathy; Male; Mediastinal Diseases; Melioidosis; Meropenem; Sensitivity and Specificity; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Burkholderia gladioli is an unusual organism that has become increasingly responsible for infections in patients who are immunosuppressed, including patients who have undergone solid organ transplantation. This article presents a patient in whom a mediastinal mass due to Burkholderia gladioli developed after lung transplantation. A review of the literature is also presented.

Topics: Abscess; Adult; Anti-Bacterial Agents; Burkholderia gladioli; Burkholderia Infections; Combined Modality Therapy; Cystic Fibrosis; Diagnosis, Differential; Drainage; Drug Therapy, Combination; Humans; Infusions, Intravenous; Lung Transplantation; Male; Mediastinal Diseases; Meropenem; Opportunistic Infections; Postoperative Complications; Thienamycins; Tobramycin; Tomography, X-Ray Computed