A case report

Abstract

Rationale:Melioidosis is an emerging infectious disease caused by Burkholderia pseudomallei. To our knowledge, there have been very few cases of splenic abscesses due to melioidosis in Hainan, China.Patient concerns:The patient was a 55-year-old male farmer, who was admitted in our hospital with persistent left epigastric dull pain accompanied by chills and febrile. One month before, the patient presented with persistent abdominal pain. After received anti-infection therapy, the subjective symptoms eased slightly, but recently he suffered from intermittent abdominal pain again.Diagnoses:Bacteria isolated from splenic pus were identified as B. pseudomallei by the Phoenix-100 system and indirect immunofluorescence.Interventions:The patient was treated by surgical excision and anti-infection therapy.Outcomes:The patient was then treated with intravenous ceftazidime and oral trimethoprim-sulfamethoxazole for 2 weeks and his clinical symptoms improved.Lessons:In endemic areas, B. pseudomallei should be considered as a causative organism of splenic abscess in patients with established risk factors. The isolation of B. pseudomallei from abscess sites is crucial to improve clinical outcomes by appropriate antimicrobial therapy coupled with surgical drainage.

Chronic Splenic Melioidosis in a Patient with Fever of Unknown Origin Diagnosed by Metagenomics Next-Generation Sequencing: An Emerging Cause and Literature Review

“… 6–8 , 10 , 14–16 Melioidosis only involving the spleen is relatively uncommon, as described in this report. 17 , 18 …”

“…[6][7][8]10,[14][15][16] Melioidosis only involving the spleen is relatively uncommon, as described in this report. 17,18 The diagnosis of melioidosis remains challenging, particularly in non-endemic areas with laboratories having no experience with B. pseudomallei. Culture-based method is the gold standard for the diagnosis of melioidosis.…”

Unusual Presentations of Abdominal Melioidosis

“…[ 1 ] It is highly prevalent in Southeast Asia, and is caused by a motile, aerobic Gram-negative bacillus called Burkholderia pseudomallei . [ 2 ] It affects adults with diabetes mellitus (37%–60%), renal disease, and alcoholism and those immunosuppressed as a result of either disease or drugs. [ 2 ] However, it has no association with HIV infection.…”

“…[ 2 ] It affects adults with diabetes mellitus (37%–60%), renal disease, and alcoholism and those immunosuppressed as a result of either disease or drugs. [ 2 ] However, it has no association with HIV infection. [ 3 ] The organism is transmitted through abraded skin defect when exposed to moist soil and rarely by inhaling or ingesting the causative agent.…”

Systemic Melioidosis With Ruptured Splenic Abscess

“…The disease is acquired through contact with contaminated soil or water by percutaneous inoculation, aerosol inhalation, or the ingestion of contaminated water or food. The case fatality rate ranges from 19% to 36% in endemic areas [1]. The risk factors being diabetes mellitus, tuberculosis, soil/water exposure history, chronic renal disease, excessive alcohol consumption, and steroid use [2].…”