Tuberculosis and Melioidosis at Distinct Sites Occurring Simultaneously

Abstract

Rationale. Both tuberculosis and melioidosis are commonly encountered infectious diseases in South East Asia. However, these conditions occur commonly in isolation, cases of coinfection of Mycobacterium tuberculosis and Burkholderia pseudomallei are rare. These cases report of the isolation of both organisms concomitantly in a single disease site. We report the first case of concomitant infection at distinct noncontiguous sites. Patient Concerns. A 64-year-old man, with chronic alcohol consumption, presented with a month long history of left-sided abdominal pain, as well as significant weight loss and fever prior to the onset of abdominal pain. Diagnosis. Disseminated tuberculosis with pulmonary and gastrointestinal involvement and a splenic abscess due to melioidosis. Interventions. The patient was treated concomitantly for pulmonary and gastrointestinal tuberculosis, as well as a splenic abscess due to melioidosis. Outcomes. The patient is reported to be well, with resolution of symptoms, as well as radiological resolution of the splenic abscess. Lessons. Both melioidosis and tuberculosis can present with a similar clinical picture, and coinfections are rare. Hence, increased awareness among clinicians and microbiologists can help in diagnosing both diseases even when it is not clinically apparent.

Coinfection of Melioidosis and Tuberculosis Causing Infective Lumbar Spondylodiscitis

“…Similar findings were also reiterated by Kingsley et al in their study from Malaysia 13 . The fact that melioidosis and TB are both endemic in South Asia gives a possibility of concurrent infection, and there are few case reports described in the literature 5,6,[14][15][16] . Apart from the clinical-radiological findings, there are even histopathology similarities in the form of granulomatous lesion, making the diagnosis even more confusing 17 .…”

Pulmonary tuberculosis and melioidosis coinfection in Brunei Darussalam: the importance of awareness and screening

“…Annually, an average of 227 TB cases were recorded in Brunei Darussalam of awareness of these coinfections. [5][6][7][8][9][10][11][12][13][14] This report documents a case of coinfection with pulmonary TB (PTB) and melioidosis in a patient with poorly controlled DM in Brunei Darussalam.…”

“…15 A literature search identified 10 reports of 13 cases of coinfection with TB and melioidosis (Table 1). [5][6][7][8][9][10][11][12][13][14] All but one occurred in males; their ages ranged from 39 to 64 years, and DM was the most common risk factor. Not all patients reported environmental or occupational exposure.…”

“…To date, there have been only 13 cases of coinfection reported in the literature, with most reported during the past 10 years, highlighting a recent increase and the importance of awareness of these coinfections. ( 5 - 14 ) This report documents a case of coinfection with pulmonary TB (PTB) and melioidosis in a patient with poorly controlled DM in Brunei Darussalam.…”