Introduction Burkholderia gladioli - is known as a phytopathogenic bacterium but has also been
identified to cause human infections in multiple cases within the last few years.
Clinical symptoms varied. Most cases were associated with cystic fibrosis, lung transplantation
or chronic granulomatous disease.
Case Report A 78 year old female patient presented with subfebrile temperatures and a progressive
rightsided odynodysphagia lasting since two days. Relevant secondary diagnoses were
COPD and rheumatoid arthritis. Upon examination a reddened protrusion of the right
lateral wall of the oropharynx reaching from the lower part of the tonsil to the epiglottic
vallecula could be found. Furthermore an oedematous swelling of the lingual surface
of the epiglottis was detected. The laboratory tests showed elevated markers of inflammation.
As primary treatment an intraoral incision and drainage of the parapharygeal abscess
with production of pus was performed. After an inadequate clinical recovery and further
diagnostics via MRI an abscess-tonsillectomy was completed. There was no trace of
fluid or pus within the wound. The intraoperative swap showed growth of Bukholderia
gladioli. Treatment with antibiotics according to resistrogram finally lead to a clinical
and paraclinical remission.
Discussion Although rarely foundin in human infections, the bacterium can manifest itself in
the form of sepsis, pneumonia, abscesses or lymphadenitis. Most of these patients
are immunodeficient, as our patient was. The therapy with aminoglycoside antibiotics
often leads, as in our case, to a recovery from the infection. The bacterial strain
of Burkholderia with its for humans partially very pathogenic subgroups is a possible
agent for biological weapons.
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