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Surgical presentation of melioidosis in India
S Mathew1, B Perakath, G Mathew
1Christian Medical College, Vellore, Tamil Nadu, India.
Background:
Melioidosis, the disease caused by Burkholderia pseudomallei, is common in Southeast Asia. It has also been reported from India, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites.
Methods:
All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated.
Results:
Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed.
Conclusion:
Melioidosis is under-diagnosed in India, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent.
Insights
Melioidosis, caused by Burkholderia pseudomallei, is often missed in India. Early diagnosis and culture of abscesses at unusual sites are crucial for effective treatment.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Melioidosis is endemic in Southeast Asia and increasingly recognized in India.
- Under-diagnosis and under-reporting of melioidosis in India are suspected.
- This study focuses on melioidosis presenting as unusual abscesses.
Observation:
- A single surgical unit evaluated culture-proven Burkholderia pseudomallei cases from 1995 to 1998.
- Patients presented with splenic abscesses and soft tissue neck abscesses.
- One patient developed severe sepsis (septicaemia).
Findings:
- All patients with melioidosis responded well to ceftazidime and/or co-trimoxazole.
- Prompt initiation of antibiotics upon diagnosis led to favorable outcomes.
- Culture of pus confirmed Burkholderia pseudomallei as the causative agent.
Implications:
- Clinicians should maintain a high index of suspicion for melioidosis in India.
- Unusual abscess presentations warrant investigation for Burkholderia pseudomallei.
- Microbiological culture is essential for accurate diagnosis and appropriate treatment of melioidosis.