Severe Hepatosplenic Abscesses and Septicemia Caused by Burkholderia thailandensis in a Hemodialysis Patient

Abstract Burkholderia thailandensis, an environmental saprophyte closely related to B. pseudomallei, is generally considered non-pathogenic but can rarely causes human disease. We report a case of B. thailandensis septicemia with hepatosplenic abscesses in a 58-year-old Thai male with end-stage kidney disease undergoing long term hemodialysis. The patient presented with prolonged fever following freshwater exposure. CT scan of chest and abdomen revealed hepatosplenic abscesses along with cavitary lung nodules. Blood culture grew B. thailandensis, confirmed by MALDI-TOF MS and 16S rRNA sequencing. This case highlights the potential of B. thailandensis to cause life-threatening infections in immunocompromised patients. It also emphasizes the importance of advance microbiological diagnostic to distinguish it from B. pseudomallei, due to their clinical and microbiological similarities but differing pathogenicity and epidemiological implication