Multiple visceral abscess in a case of melioidosis

Navaneethan, Udayakumar; Kumar, AC Ramesh; Ravi, G

doi:10.4103/0019-5359.19916

Cited by 7 publications

(5 citation statements)

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“…Though many cases have been reported as liver and splenic abscess, we did not get any case presenting as acute intestinal perforation even after searching the world literature extensively. [ 5 14 ] Ceftazidime has been the most sensitive drug for B. pseudomallei in the literature and it has been used from two to 6 weeks in various studies. [ 4 15 ] Some cases of ceftazidime resistant B. pseudomallei have already been reported from India like that of ours.…”

Section: Discussionmentioning

confidence: 99%

Melioidosis as a Cause of Acute Abdomen in Immuno-Competent Male from Eastern India

et al. 2015

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Though melioidosis is rare in India, it has gained importance as one of the most potent emerging infections. In India, the cases have been under-reported because of the lack of awareness. The majority of cases present with multifocal pyogenic infections with septicemia. We present an unusual case of melioidosis presenting as acute intestinal perforation. The organism was ceftazidime resistant, and we successfully treated the case with imipenem and doxycyclin. This case highlights ruling out the possibility of melioidosis in acute abdomen and existence of ceftazidime resistant cases in India.

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Section: Discussionmentioning

confidence: 99%

Melioidosis as a Cause of Acute Abdomen in Immuno-Competent Male from Eastern India

et al. 2015

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“…Subsequently, only a few case reports of isolated visceral abscesses including brain and liver abscesses have been described in the literature. [29][30][31] A little later, Vidyalakshmi et al 32 reported the isolation of B. pseudomallei from six pus samples of a series of 25 patients with culture-proven melioidosis consisting of supraclavicular mass (two), psoas abscess (two), scalp abscess (one), and gluteal abscess (one). Furthermore, of 32 culture-proven cases between 2005 and 2010, localized disease was observed in 43.8%, usually as septic arthritis or abscesses.…”

Section: Discussionmentioning

confidence: 99%

Identification and Characterization of Burkholderia pseudomallei from Localized Pyogenic Infections in Eastern India: A Clinico-Microbiological Study

Purushotham

Mohanty

Preetam

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Melioidosis, caused by Burkholderia pseudomallei, is increasingly recognized in several regions of the globe. The present study was performed to identify and determine the frequency of B. pseudomallei infection in localized pyogenic lesions in eastern India and describe their clinico-microbiological profile. Pus samples were subjected to standard microbiological techniques for isolation and identification of various bacteria, including B. pseudomallei, which were confirmed by PCR. The clinical and demographic details of patients with melioidosis and antimicrobial susceptibility pattern of B. pseudomallei isolates were analyzed. Of 245 samples, 126 (51.4%) were culture positive, yielding 137 isolates. Staphylococcus aureus was the predominant pathogen accounting for 54 (39.4%) isolates, followed by B. pseudomallei accounting for 34 (24.8%) isolates. The mean age of the patients with melioidosis was 39.1 years, with males (24/34; 70.6%) being affected more than females (10/34; 29.4%). A majority of the patients were laborers (12/34; 35.3), followed by homemakers (8/34; 23.5%). Head and neck abscesses (35.3%) were the most common presentation followed by pyogenic lesions of the musculoskeletal system (32.3%) and deep organ abscesses (23.5%). Clinical resolution of infection was observed in 31 (91.2%) patients, relapse in two (5.9%) patients, and death in one (2.9%) patient, respectively. Susceptibility testing revealed all B. pseudomallei isolates to be completely susceptible to the following antimicrobials: ceftazidime, trimethoprim–sulfamethoxazole, imipenem, and doxycycline, with one (2.9%) resistant to amoxicillin–clavulanic acid. Burkholderia pseudomallei is an emerging etiological agent of localized pyogenic infections in eastern India, affecting a mainly adult male population. An increased vigilance along with appropriate diagnostic techniques helps in accurate diagnosis facilitating appropriate therapy.

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“…Melioidosis with multiple organs involved causes abscesses in those locations, such as liver, spleen, renal, and results in imaging manifestation of abscess on CT or MRI. Nevertheless, in our case, the organs were involved in sequence and the clinical symptoms were atypical, hampering the diagnosis [14].…”

Section: Discussionmentioning

confidence: 99%

Multi-systemic melioidosis: a clinical, neurological, and radiological case study from Hainan Province, China

Huang

Chen

et al. 2018

BMC Infect Dis

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BackgroundMelioidosis is a tropical disease caused by Burkholderia pseudomallei (B. pseudomallei). It can infect any organ system and lead to multiple abscesses. A few studies reported that central nervous system (CNS) is also involved.We present a diabetic patient with multi-systemic melioidosis that affected the CNS, thorax, and spleen. The aim was to study the clinical and radiological features of melioidosis and enhance understanding of the disease.Case presentationA 38-year-old male presented with cough and expectoration mixed with blood for several days. Chest computed tomography (CT) showed a patchy opacity in his left lung, and multiple low-density lesions in his spleen. After 10 days of antibiotics treatment, his clinical symptoms improved and he was discharged from the hospital. But 8 months later, the patient experienced sudden onset of left limb weakness and seizure and was re-admitted to the hospital. Brain CT indicated a low-density lesion over the right frontal lobe, and magnetic resonance imaging (MRI) indicated a well-enhanced lobulated lesion with multiple diffusion restriction areas in the lesion. He had a neuronavigation-guided open surgery but no malignancy was found. B. pseudomallei was cultured from the operative samples. After 4 months of systemic and intraventricular antibiotic administration treatment, he recovered complete consciousness with left hemiparesis.ConclusionsMulti-systemic melioidosis may present atypical clinical, neurological, and radiological manifestations. It is extremely important to accurately diagnose before treatment is selected. CNS melioidosis in early stage manifests similar symptoms to malignancy or stroke. It might mislead to a false diagnose. Diffusion weighted imaging (DWI) can help in differentiate abscesses from cystic tumours.

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Multiple visceral abscess in a case of melioidosis

Cited by 7 publications

References 1 publication

Melioidosis as a Cause of Acute Abdomen in Immuno-Competent Male from Eastern India

Melioidosis as a Cause of Acute Abdomen in Immuno-Competent Male from Eastern India

Identification and Characterization of Burkholderia pseudomallei from Localized Pyogenic Infections in Eastern India: A Clinico-Microbiological Study

Multi-systemic melioidosis: a clinical, neurological, and radiological case study from Hainan Province, China

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