Post-Tonsillectomy Fulminant Burkholderia Sepsis at High Altitude; A Rare
Complication of a Common Surgery: A Case Report
Parul Verma1*, Kamal Deep Joshi2, Dharmendra Kumar Singh3, Tanuj Madan4, Harleen Kaur5 and Rohit Singh6
1MS (ENT), Consultant, Military Hospital Jalandhar, Punjab, India
2MS (ENT), Classified Specialist (ENT) and Head-Neck Oncosurgeon, Command Hospital Chandimandir, Panchkula, Haryana, India
3MS (ENT), Senior Advisor and Head of Department (ENT), Command Hospital Chandimandir, Panchkula, Haryana, India
4MS (ENT), Assistant Professor, Military Hospital Jabalpur, Madhya Pradesh, India
5Assistant Professor, Microbiology, Command Hospital Chandimandir, Panchkula, Haryana, India
6MS (ENT), Assistant Professor, Military Hospital Gwalior, Madhya Pradesh – 474006, India
*Corresponding Author: Parul Verma, MS (ENT), Consultant, Military Hospital Jalandhar, Punjab, India.
Received:
November 03, 2025; Published: November 20, 2025
Abstract
This case reports a 30-year-old immunocompetent male residing in high altitude region (3500 meters), who experienced severe post-tonsillectomy systemic infection of Burkholderia cepacia including septicaemia, multiorgan dysfunction syndrome (MODS) and disseminated intravascular coagulation (DIC). Aggressive management was necessary, emphasizing the importance of vigilant monitoring and prompt intervention in post-tonsillectomy care to address significant bleeding and bacterial infections effectively
Keywords:Multiorgan Dysfunction Syndrome (MODS); Disseminated Intravascular Coagulation (DIC)
References
- Discolo C M., et al. “Infectious indications for tonsillectomy”. Pediatric Clinics of North America2 (2003): 445-458.
- Cohen D and Dor M. “Morbidity and mortality of post-tonsillectomy bleeding: analysis of cases”. Journal of Laryngology and Otology1 (2008): 88-92.
- Windfuhr JP., et al. “Life-threatening post-tonsillectomy hemorrhage”. Laryngoscope 8 (2008): 1389-1394.
- Crysdale WS and Russel D. “Complications of tonsillectomy and adenoidectomy in 9409 children observed overnight”. Canadian Medical Association Journal10 (1986): 1139-1142.
- Yildirim I., et al. “Bacteraemia during tonsillectomy”. The Journal of Laryngology & Otology8 (2003): 619-623.
- Timmers-Raaijmaakers BC., et al. “Invasive group A streptococcal infection after tonsillectomy”. Pediatric Infectious Disease Journal 10 (2003): 929-931.
- Wilson PF., et al. “Invasive group A Streptococcus resulting in sepsis and abdominal wall abscess after adenotonsillectomy”. Laryngoscope5 (2015): 1230-1232.
- Zautner AE., et al. “Chronisch rezidivierende Tonsillopharyngitis infolge einer Burkholderia-cenocepacia-Infektion: 2 Fallberichte [Recurrent tonsillopharyngitis associated with Burkholderia cenocepacia : two case reports]”. HNO5 (2009): 515-518.
- Sarwat T., et al. “Burkholderia Septicemia: A Case Report”. Journal of Medical Sciences and Health 1 (2021): 95-96.
- Nguyen-Dang K., et al. “Hospital-acquired pneumonia due to Burkholderia cepacia in a thalassemia pregnancy with postoperative eclampsia: A case report”. Respiratory Medicine Case Reports 49 (2024): 102021.
- Stettler GR., et al. “Burkholderia Cepacia Infection in an Immunocompetent Patient Following Pancreaticoduodenectomy”. American Surgery4 (2023): 1099-1101.
- Rakesh Miryala., et al. “Iatrogenic postoperative spondylodiscitis attributed to Burkholderia cepacia infection in an immunocompetent patient”. Surgical Neurology International 12 (2021): 138
- Weinstein L., et al. “Cervical osteomyelitis caused by Burkholderia cepacia after rhinoplasty”. The Journal of Infection in Developing Countries1 (2008): 76-77.
- Tavares M., et al. “Adaptation and Survival of Burkholderia cepacia and B. contaminans during Long-Term Incubation in Saline Solutions Containing Benzalkonium Chloride”. Frontiers in Bioengineering and Biotechnology 630 (2020).
- Tavares M., et al. “Burkholderia cepacia complex Bacteria: a Feared Contamination Risk in Water-Based Pharmaceutical Products”. Clinical Microbiology Review3 (2020).
- Balkhy HH., et al. “A National Guard outbreak of Burkholderia cepacia infection and colonization secondary to intrinsic contamination of Albuterol nebulization solution”. American Journal of Infection Control 3 (2005): 182-188.
- Uehlinger S., et al. “Identification of specific and universal virulence factors in Burkholderia cenocepacia strains by using multiple infection hosts”. Infection and Immunity9 (2009): 4102-4110.
- Lalitha P., et al. “Postoperative endophthalmitis due to Burkholderia cepacia complex from contaminated anaesthetic eye drops”. British Journal of Ophthalmology11 (2014): 1498-1502.
- Basnyat B., et al. “Infections at high altitude”. Clinical Infectious Disease11 (2001): 1887-1891.
- Roy R. High altitude induced laryngopharyngitis sicca”. Medical Journal Armed Forces India 72 (2016): S169-S172.
- Liu F., et al. “Effects of altitude on human oral microbes”. AMB Express1 (2021): 41.
- Jiang P., et al. “Effects of long-term high-altitude exposure on fibrinolytic system”. Hematology (Amsterdam, Netherlands) 26 (2021): 503-509.
- Zhao CC., et al. “Does living at high altitude increase the risk of bleeding events after total knee arthroplasty? A retrospective cohort study”. International Orthopaedics1 (2023): 67-74.
Citation
Copyright