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Melioidosis: an uncommon cause of neck abscess

Abu Bakar Zulkiflee1, Narayanan Prepageran, Rajan Philip

  • 1Department of Otolaryngology, University Malaya Medical Center, University Malaya, Kuala Lumpur. ab_zulkiflee@yahoo.com

American Journal of Otolaryngology
|December 7, 2007
PubMed
Abstract

Insights

Neck melioidosis, caused by Burkholderia pseudomallei, can present as a parapharyngeal abscess. Early consideration in endemic regions is crucial for timely diagnosis and effective treatment of this potentially fatal infection.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Melioidosis is a severe bacterial infection caused by Burkholderia pseudomallei, endemic in Southeast Asia.
  • Transmission occurs through inhalation, ingestion, or skin contact with contaminated soil or water.
  • While systemic melioidosis has a high mortality rate, localized infections can be subtle, leading to diagnostic delays.

Observation:

  • This case report details a patient with neck melioidosis presenting as a parapharyngeal abscess.
  • The patient's condition required surgical intervention (incision and drainage) and antimicrobial therapy.

Findings:

  • Successful management was achieved with a 6-week course of intravenous ceftazidime and co-trimoxazole.
  • Subsequent eradication therapy with oral co-amoxiclav was administered to ensure complete resolution.

Implications:

  • Neck melioidosis should be included in the differential diagnosis of neck abscesses, particularly in endemic areas.
  • Awareness is critical for healthcare providers managing patients from or who have visited endemic regions.
  • Prompt diagnosis and appropriate antimicrobial treatment are vital for improving outcomes in localized melioidosis.

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