Children with melioidosis in Far North Queensland are commonly bacteraemic and have a high case fatality rate

Paediatric melioidosis is uncommon in Northern Australia. In the Northern Territory, children with melioidosis often report an inoculation event and localised skin and soft tissue infections predominate. However, in Far North Queensland, children with melioidosis are frequently bacteraemic and have a high case fatality rate. To confirm this observation, all culture-confirmed cases of Burkholderia pseudomallei processed at Cairns Hospital between 1998 and March 2017 were reviewed. During the study period, B. pseudomallei was isolated from 223 people; ten (4%) were children (aged from three days to 14 years). Bacteraemia occurred in 6/10 (60%) children compared with 161/213 (76%) adults (p=0.24). The primary diagnosis was localised, cutaneous disease in three children, meningoencephalitis in two and pneumonia in two. Three had bacteraemia with no primary source evident. No child had a parotid abscess or liver abscess. Five children (50%) died, and all of whom were bacteraemic.