Related Experiment Video

Updated: Jul 10, 2026

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
10:08

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens

Published on: April 17, 2026

Spectra of central nervous system melioidosis

Kalai Arasu Muthusamy1, Vicknes Waran, Savithri D Puthucheary

  • 1University Laboratory of Physiology, Oxford University, Parks Road, Oxford OX1 3PT, United Kingdom. kalai.muthusamy@physiol.ox.ac.uk

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|October 30, 2007
PubMed

Insights

Central nervous system (CNS) melioidosis, caused by Burkholderia pseudomallei, is rare. This study details three CNS melioidosis cases, including brain and spinal epidural abscesses, with good recovery after surgical drainage and antibiotics.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Central nervous system (CNS) melioidosis, a rare infection caused by Burkholderia pseudomallei, presents diagnostic and therapeutic challenges.
  • Melioidosis is endemic in tropical regions, with CNS involvement being an infrequent but severe manifestation.

Observation:

  • A retrospective study identified three cases of CNS melioidosis among over 160 melioidosis cases since 1978.
  • Patients presented with brain abscess (two cases) and spinal epidural abscess (one case).
  • Predisposing factors included aboriginal ethnicity and diabetes mellitus.

Findings:

  • Neurological symptoms included limb weakness, cranial nerve palsies (6th and 7th), and visual disturbances.
  • Imaging revealed abscess formation, subdural and spinal epidural collections, osteomyelitis, and sagittal sinus thrombosis.
  • Bacteriological diagnosis was confirmed post-surgical drainage.

Implications:

  • Prompt surgical drainage combined with appropriate long-term antibiotic therapy is crucial for favorable outcomes in CNS melioidosis.
  • Early recognition of neurological signs and advanced imaging are vital for timely diagnosis and management.
  • This study highlights the importance of considering Burkholderia pseudomallei in the differential diagnosis of CNS infections, especially in endemic areas.

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