類鼻疽（melioidosis）是由類鼻疽桿菌（Burkholderia pseudomallei）感染所引起的地方性傳染病，此傳染病目前在台灣雖不多見，但由於感染後的臨床表徵不具特異性且容易有嚴重的併發症，因此常導致高死亡率。類鼻疽目前主要流行區域在東南亞及澳洲北部，常見的臨床表徵多為肺炎，本案例是類鼻疽桿菌感染，但呈現特異的臨床表徵—中風，且半年內又再度復發。此傳染病目前建議起始治療的首選抗生素為ceftazidime，嚴重感染者可考慮使用carbapenem藥物，根除治療則以口服4種藥物chloramphenicol、doxycycline、sulfamethoxazole/trimethoprim合併治療效果最佳；由於此疾病的復發率高，因此須確實完成整個療程及衛教病患預防感染的措施，方能達到成功之治療效果。

Melioidosis, which doesn’t occur frequently in Taiwan, is an infectious disease caused by Burkholderia pseudomallei in endemic areas. As a high mortality disease, melioidosis produces no apparent clinical manifestations and readily arises severe complications. The majority of cases are distributed in Southeast Asia and Northern Australia. Pneumonia is the commonest clinical presentation of patients with melioidosis. An unusual case of melioidosis presenting with stroke syndrome is described here and this case is also a later relapse of melioidosis. Ceftazidime is the drug of choice for initial intensive therapy for melioidosis and carbapenem is used in severe case. A four-drug regimen of chloramphenicol, doxycycline, and sulfamethoxazole/trimethoprim is the most efficacious to eradicate the disease. Due to its high relapse rate, completing the course of eradication therapy and educating patients how to prevent infection are the most important way to treat successfully.