Burkholderia cepacia Differential Diagnoses

Updated: Mar 15, 2023
  • Author: Sara Ahmed, MBBS, MRCP(UK), FCPS; Chief Editor: Michael Stuart Bronze, MD  more...
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Diagnostic Considerations

B cepacia recovered from blood cultures may represent infection, pseudo infection, or actual infection from contaminated intravenous fluids (infusate-related).

Regard the recovery of B cepacia from the respiratory secretions or urine of catheterized patients as colonization until proven otherwise.

B cepacia is a common cause of catheter-associated bacteriuria in hospitalized patients. B cepacia commonly colonizes the urine and is potentially pathogenic only in individuals with impaired host defenses (eg, patients on steroids or those with diabetes, systemic lupus erythematosus [SLE], multiple myeloma, cirrhosis, or chronic granulomatous disease).

B cepacia is an extremely rare cause of nosocomial pneumonia. In ventilated patients with presumed nosocomial pneumonia who have fever, pulmonary infiltrates, and leukocytosis, B cepacia cultured from respiratory secretions generally represents colonization rather than infection.

Nosocomial infections caused by B cepacia include the following:

  • Catheter-associated bacteriuria - Indwelling urinary catheters
  • Central line-associated bloodstream infection - Central venous catheters (CVCs)
  • Urinary tract infection - following urinary tract instrumentation
  • Secondary bacteremia - Arterial monitoring devices
  • Pseudobacteremia - Contamination of blood during collection and/or processing of blood cultures

There also have been reports of B cepacia as a cause of endocarditis in individuals with drug addiction or prosthetic heart valves, endophthalmitis and subdural empyema, brain abscesses, and meningitis. [5, 6, 7, 8, 9, 10, 11]