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This article reports on a case of melioidosis presenting as suppurative epididymo-orchitis with chronic prostatitis in a patient after a trip to Myanmar. In the report, a 52-year-old Caucasian male patient, living in Gabon since 1979 and working as a geophysicist prospector, was repatriated to France for treatment of an uncommon form of epididymo-orchitis. He had just previously spent 2 months in Myanmar to explore new plots. During the exploration of the rural regions from Kyunbin to Shewpitha, he walked several kilometers all day long in contact with muddy water, paddy fields, and water mains full of mud. He crossed rivers, slept directly on the ground, and fed on local food and drink. He had no underlying disorders such as diabetes, renal disease, or immunodeficiency. Four days after returning from this trip, he complained of high fever, bilateral pain in the lumbar area, and left: epididymo-orchitis. He was treated for 7 days with intramuscular gentamicin, oral amoxicillin clavulanate, and an anti-inflammatory drug without any microbiologic identification. The fever disappeared, but the patient still complained of a swollen and hardened but painless testis and required repatriation. Upon admission, moderate biologic abnormalities were observed. Leukocytosis was noted and C reactive protein was increased at 17.8 mg/dL. Oral ofloxacin and minocycline were given empirically for 2 days because of the intracellular germs commonly involved in a likely sexually transmitted disease. However, because of lack of improvement, the patient was then empirically treated with intravenous ceftriaxone and initializing and oral ofloxacin. Antibiotic susceptibility testing was performed by disk diffusion test and then the patient was treated with oral trimethoprim-sulfamethoxazole and intravenous ceftazidime for 1 month; the left testis healed rapidly and three months until the patient remained asymptomatic after 12 months' follow-up.

Two cases of rhinoscleroma in patients infected with the human immunodeficiency virus (HIV) who had stayed in an area of endemic Klebsiella rhinoscleromatis are reported. One of the patients presented with oropharyngeal lesions, an unusual clinical picture. Both patients suffered from a major cellular immune deficiency. The importance of Klebsiella rhinoscleromatis infection in AIDS-related oropharyngeal pathology and the possible treatment of such infection in HIV-positive patients are not yet clearly established. [ABSTRACT FROM PUBLISHER]