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CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2021; 11(01): 50-53
DOI: 10.1055/s-0040-1721232
Case Report

Melioidosis: A Fulminant Infection in a Patient with Uncontrolled Diabetes

Nandakishore Baikunje
1   Department of Pulmonary Medicine, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, Karnataka, India
,
Suresh Gangaramajalu
2   Department of General Medicine, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, Karnataka, India
,
Giridhar Belur Hosmane
1   Department of Pulmonary Medicine, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, Karnataka, India
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Abstract

Melioidosis is an endemic infection in Southeast Asia and Northern Australia commonly manifesting with pneumonia and localized skin infection. Though most exposures do not lead to severe illness, a fulminant infection can occur among patients with risk factors. A 59-year-old male presented with cough with expectoration and fever for 1 week. He had diabetes for 10 years with poorly controlled blood sugars. Contrast-enhanced computerized tomography (CECT) of thorax showed right upper lobe consolidation with diffuse ground-glass opacities in right upper lobe along with microabscesses in liver and spleen. Sputum culture and Xpert mycobacterium tuberculosis complex and resistance to rifampin (MTB/RIF) for tuberculosis were negative. Bronchoalveolar lavage culture grew Burkholderia pseudomallei. He was treated with initial intensive therapy with injection amoxicillin-clavulanic acid for 2 weeks and subsequently started on eradication therapy with tablet trimethoprim-sulfamethoxazole. Diagnosis of melioidosis should be considered in a patient of pneumonia with multiorgan involvement in an endemic area, especially with underlying risk factors.

Keywords

melioidosis - Burkholderia pseudomallei - microabscess


Publication History

Article published online:
02 December 2020

© 2020. Nitte University (Deemed to be University). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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