Melioidosis Presenting as Fever and Jaundice: A Rare Presentation

Abstract

Melioidosis caused by the environmental Gram-negative bacillus Burkholderia pseudomallei is endemic in northern Australia and Southeast Asia and is being described increasingly from south and west coastal regions of India. Melioidosis is known to have high mortality (14-50%) and the risk factors associated with it are diabetes mellitus and heavy alcohol abuse. Melioidosis primarily presents as pneumonia, genitourinary infection and bacteremia. We present a case of Melioidosis from North India, a 56-year-old diabetic male, presenting with fever and jaundice. His blood culture was positive for the B. pseudomallei. The hepatic involvement was in the form of jaundice with serum bilirubin value of more than 12 mg/dL, hepatic enzymes more than ten times high and without hepatic abscess. He improved with intravenous antibiotics with complete normalization of liver function tests. ( J CLIN EXP HEPATOL 2014;4:172-174)

Pediatric suppurative parotitis caused by Burkholderia pseudomallei

“…Infection with B. pseudomallei can be contracted via several routes, including subcutaneous inoculation, ingestion, and likely inhalation [1]. Melioidosis is known as a ‘great mimicker’ since it may mimic several diseases from pyogenic bacterial infection to tuberculosis, and there is no pathognomonic sign of melioidosis [2–4]. The disease has an acute and a subacute forms and also a chronic relapsing state with associated high mortality.…”

Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise

“…The extra-pulmonary involvement is more common in melioidosis than TB and less challenging in diagnosis, still it is missed most often [19,20]. Deranged liver function tests along with hepatomegaly is another entity in this case, which is more common in melioidosis than TB [21]. The higher blood glucose level among the melioidosis infected individuals is an indicator of uncontrolled diabetes, which is a well-established risk factor for both the diseases.…”

Melioidosis Presenting as Parotid Abscess in an Adult - A Case Report

“…[8] Melioidosis is known as a 'remarkable imitator' since it mimics several diseases from pyogenic bacterial infection to tuberculosis, and there is no pathognomonic sign of melioidosis. [9][10][11] Melioidosis manifests as inapparent infection, acute localized suppurative infection, acute pulmonary infection, acute septicemia infection or chronic suppurative infection. Risk factors for the infection include diabetes mellitus, alcoholism, renal insufficiency, chronic liver disease, malignancy, connective tissue disorders and chronic steroid use.…”