Burkholderia cepacia Differential Diagnoses

Updated: Oct 27, 2015
  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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DDx

Diagnostic Considerations

B cepacia recovered from blood cultures may represent infection, pseudoinfection, 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
  • Intravenous line infections - Central venous catheters (CVCs)
  • Urosepsis - Following urinary tract instrumentation
  • Secondary bacteremia - Arterial monitoring devices
  • Pseudobacteremia - Contamination of blood during collection and/or processing of blood cultures