The patient: A 56-year-old woman in Maryland
The symptoms: The woman was hospitalized after experiencing fever, cough and chest pain for about two days.
What happened next: Scans of the patient's chest revealed signs of pneumonia, and lab results suggested she had a higher-than-normal number of immune cells in her blood. Suspecting an infection, doctors tested the patient's blood for bacteria and found Burkholderia pseudomallei, a species that's widespread in Australia and Southeast Asia. However, the woman hadn't been out of the country.
The diagnosis: The woman had melioidosis, a bacterial infection caused by a microbe that lives in soil and water in tropical and subtropical regions. People can become infected by breathing in dust or water contaminated with B. pseudomallei, or by touching contaminated soil or water, especially with broken skin.
The treatment: The patient was given antibiotics that resolved her fever and normalized her immune cell count. She was discharged after 11 days but continued getting antibiotics via IV at an outpatient clinic. A few weeks later, though, the patient's fever returned, and she was readmitted for a more extensive antibiotic regimen. She was discharged a week later but ultimately had to remain on antibiotics for months to completely clear the infection.
What makes the case unique: Historically, most melioidosis cases detected in the U.S. have been connected to international travel. In this case, though, the woman was exposed to the bacteria much closer to home.
The patient had never traveled outside the continental U.S., but she owned two fish tanks. While looking for the source of the bacteria in her home, scientists gathered samples of water, gravel, filters and artificial plants from both tanks and found that several samples from one tank tested positive for B. pseudomallei. The patient had purchased the tank and supplies from a large retail store, and the water in the contaminated tank was "persistently cloudier" than the other, she said. Several sets of fish that she had kept in that tank had died, and she recalled reaching her bare hands and arms into the water to clean the tank.
The scientists concluded that this case marked the first time someone caught melioidosis from a fish tank, potentially due to imported aquarium supplies or the fish themselves being contaminated.
In the years since this case, scientists have found B. pseudomallei in soil and water samples from the Gulf Coast region of Mississippi, and data suggest that nearby states, like Texas, may also harbor the bacteria. Therefore, these states could see more local cases of melioidosis in the future. Recent cases have also been tied to contaminated, imported products, including an aromatherapy spray.
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