Melioidosis on Phu Quoc Island, Vietnam: a retrospective case series from a remote tropical setting.
11 affiliations
- 1Vinmec Phu Quoc, Vinmec International Hospital, Phu Quoc Special Zone, An Giang, Vietnam. [email protected].
- 2Department of Laboratory Medicine, Vinmec Riverside, Vinmec International Hospital, Hanoi, 100000, Vietnam. [email protected].
- 3Vinmec - VinUni Institute of Immunology, College of Health Sciences, VinUniversity, Hanoi, 100000, Vietnam. [email protected].
- 4Vinmec - VinUni Institute of Immunology, College of Health Sciences, VinUniversity, Hanoi, 100000, Vietnam.
- 5Vinmec Times City, Vinmec International Hospital, Hanoi, 100000, Vietnam.
- 6Innovations in Health Sciences, VinUniversity, Hanoi, Vietnam.
- 7Vinmec Phu Quoc, Vinmec International Hospital, Phu Quoc Special Zone, An Giang, Vietnam.
- 8Scientific Research Management Center, Vinmec International Hospital, Hanoi, 100000, Vietnam.
- 9Department of Laboratory Medicine, Vinmec Riverside, Vinmec International Hospital, Hanoi, 100000, Vietnam.
- 10Vinmec Ocean Park 2, Vinmec International Hospital, Hung Yen, Vietnam. [email protected].
- 11Vinmec Phu Quoc, Vinmec International Hospital, Phu Quoc Special Zone, An Giang, Vietnam. [email protected].
Abstract
Background
Melioidosis, caused by Burkholderia pseudomallei, is an important but frequently under-recognized cause of severe infection in tropical regions, including Vietnam. Although cases have been reported from several parts of the country, published clinical data from remote island settings remain scarce. To our knowledge, no clinical case series of melioidosis from Phu Quoc Island has been previously reported. This study describes the clinical presentations, underlying comorbidities, management, and outcomes of patients diagnosed with melioidosis at a tertiary hospital on Phu Quoc Island, Vietnam.Case presentation
We retrospectively reviewed all patients with culture-confirmed melioidosis admitted to Vinmec Phu Quoc General Hospital between July 2022 and February 2026. Archived isolates underwent molecular confirmation using a TTS1-targeted quantitative polymerase chain reaction (qPCR) assay, followed by recA gene sequencing. Nine patients were included. Clinical, laboratory, microbiological, radiological, treatment, and outcome data were extracted from medical records. Pneumonia was the predominant manifestation, occurring in seven patients, and eight patients presented with bacteremic disease. Diabetes mellitus was the most common underlying condition (7/9), followed by chronic liver disease and previous tuberculosis. Most patients were admitted with sepsis, including four cases complicated by septic shock. Two patients developed rapidly progressive pulmonary melioidosis with acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) and died despite intensive antimicrobial and supportive therapy, including one previously healthy individual. The remaining seven patients survived. TTS1 qPCR confirmed all available isolates, while recA sequencing demonstrated the presence of at least two closely related sequence variants among circulating isolates. Antimicrobial susceptibility testing by broth microdilution showed preserved susceptibility to amoxicillin/clavulanic acid, ceftazidime, imipenem, and trimethoprim/sulfamethoxazole in all tested isolates.Conclusion
This report represents, to our knowledge, the first published clinical case series of melioidosis from Phu Quoc Island. The findings highlight the broad clinical spectrum of melioidosis and its potential for rapid progression to life-threatening pneumonia, septic shock, and multiorgan failure. Clinicians should maintain a high index of suspicion in patients presenting with severe pneumonia or sepsis, particularly during the rainy season and among individuals with diabetes mellitus or chronic liver disease. Strengthening conventional microbiological capacity, including timely blood culture, accurate organism identification, and standardized antimicrobial susceptibility testing, remains essential for improving diagnosis and patient outcomes in geographically isolated settings.
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BibTeX
@article{le2026melioidosis,
title = {{Melioidosis on Phu Quoc Island, Vietnam: a retrospective case series from a remote tropical setting.}},
author = {Duy-Cuong Le and Dinh-Dung Nguyen and Thuy-Hang Thi Nguyen and Hanh Vu and Xuan-Dat Mai and Thu-Ha Nguyen and Nu Thi Nguyen and Huyen-Trang Thi Le and Thao-Loan Thi Truong and Hong-Sa Thi Nguyen and Mai Thi Nguyen and Nhat-Tan Nguyen Hoang and Linh Thi Nguyen and Anh-Khoi Nguyen and Ha Hong Pham and Thien-Thanh Le and Thanh-Ha Thi Ly and Xuan-Hung Nguyen and Ngoan Tran Le and Hoa Thi Thanh Hoang and Thu-Hien Thi Tran and Quoc-Hung Doan and Duc-Dinh Vu},
journal = {BMC infectious diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14150-4},
url = {https://europepmc.org/article/MED/43009814},
note = {CC BY},
}
RIS
TY - JOUR
TI - Melioidosis on Phu Quoc Island, Vietnam: a retrospective case series from a remote tropical setting.
AU - Duy-Cuong Le
AU - Dinh-Dung Nguyen
AU - Thuy-Hang Thi Nguyen
AU - Hanh Vu
AU - Xuan-Dat Mai
AU - Thu-Ha Nguyen
AU - Nu Thi Nguyen
AU - Huyen-Trang Thi Le
AU - Thao-Loan Thi Truong
AU - Hong-Sa Thi Nguyen
AU - Mai Thi Nguyen
AU - Nhat-Tan Nguyen Hoang
AU - Linh Thi Nguyen
AU - Anh-Khoi Nguyen
AU - Ha Hong Pham
AU - Thien-Thanh Le
AU - Thanh-Ha Thi Ly
AU - Xuan-Hung Nguyen
AU - Ngoan Tran Le
AU - Hoa Thi Thanh Hoang
AU - Thu-Hien Thi Tran
AU - Quoc-Hung Doan
AU - Duc-Dinh Vu
PY - 2026
DA - 2026/08/13
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14150-4
UR - https://europepmc.org/article/MED/43009814
AB - Background Melioidosis, caused by Burkholderia pseudomallei, is an important but frequently under-recognized cause of severe infection in tropical regions, including Vietnam. Although cases have been reported from several parts of the country, published clinical data from remote island settings remain scarce. To our knowledge, no clinical case series of melioidosis from Phu Quoc Island has been previously reported. This study describes the clinical presentations, underlying comorbidities, management, and outcomes of patients diagnosed with melioidosis at a tertiary hospital on Phu Quoc Island, Vietnam.Case presentation We retrospectively reviewed all patients with culture-confirmed melioidosis admitted to Vinmec Phu Quoc General Hospital between July 2022 and February 2026. Archived isolates underwent molecular confirmation using a TTS1-targeted quantitative polymerase chain reaction (qPCR) assay, followed by recA gene sequencing. Nine patients were included. Clinical, laboratory, microbiological, radiological, treatment, and outcome data were extracted from medical records. Pneumonia was the predominant manifestation, occurring in seven patients, and eight patients presented with bacteremic disease. Diabetes mellitus was the most common underlying condition (7/9), followed by chronic liver disease and previous tuberculosis. Most patients were admitted with sepsis, including four cases complicated by septic shock. Two patients developed rapidly progressive pulmonary melioidosis with acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) and died despite intensive antimicrobial and supportive therapy, including one previously healthy individual. The remaining seven patients survived. TTS1 qPCR confirmed all available isolates, while recA sequencing demonstrated the presence of at least two closely related sequence variants among circulating isolates. Antimicrobial susceptibility testing by broth microdilution showed preserved susceptibility to amoxicillin/clavulanic acid, ceftazidime, imipenem, and trimethoprim/sulfamethoxazole in all tested isolates.Conclusion This report represents, to our knowledge, the first published clinical case series of melioidosis from Phu Quoc Island. The findings highlight the broad clinical spectrum of melioidosis and its potential for rapid progression to life-threatening pneumonia, septic shock, and multiorgan failure. Clinicians should maintain a high index of suspicion in patients presenting with severe pneumonia or sepsis, particularly during the rainy season and among individuals with diabetes mellitus or chronic liver disease. Strengthening conventional microbiological capacity, including timely blood culture, accurate organism identification, and standardized antimicrobial susceptibility testing, remains essential for improving diagnosis and patient outcomes in geographically isolated settings.
SN - 1471-2334
ER -