A Rare Case of Neuromelioidosis Presenting As Brain Abscess in Patient Complaining of Long Standing Headache

Abstract

Melioidosis is a rare disease caused by Burkholderia pseudomallei, which may manifest with varying degrees of organ involvement, ranging from isolated organ to multi-systemic impairment. Patients with melioidosis may exhibit a wide spectrum of symptoms, from asymptomatic to severely ill. While there have been reported cases of melioidosis affecting various organs, there is limited information available on its neural involvement. In this unique case, we present a patient with no specific symptoms other than a persistent headache, who possesses only type 2 diabetes mellitus and old age as potential risk factors. Notably, the patient has no history of trauma or surgery that might have contributed to the infection. Upon MRI examination, multiple abscesses were discovered in the left parieto-occipito-temporal region. Subsequent culturing of these abscesses confirmed the presence of B. pseudomallei. The patient underwent a 4-week treatment regimen involving intravenous ceftazidime and oral double-strength co-trimoxazole. At the two-week mark of this therapy, the patient returned for a scheduled follow-up and exhibited no symptoms, remaining in good health ever since.