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Updated: Jun 30, 2026
07:27
Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis
Published on: February 24, 2023
Tuberculosis mimicked by melioidosis
K Vidyalakshmi1, M Chakrapani, B Shrikala
1Department of Microbiology, Kasturba Medical College, Mangalore, India. k.vidyalakshmi@lycos.com
Summary
Melioidosis is often misdiagnosed as tuberculosis (TB) in India. High fever, neutrophilic leucocytosis, and diabetes mellitus in patients with high ESR should raise suspicion for melioidosis.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Tuberculosis (TB) treatment is common in TB-endemic regions like India.
- Melioidosis, caused by Burkholderia pseudomallei, is frequently underdiagnosed in India due to low awareness.
- Lack of a high index of suspicion contributes to melioidosis underdiagnosis.
Purpose of the Study:
- To analyze cases of suspected TB initially treated empirically but later confirmed as melioidosis.
- To identify discriminatory parameters distinguishing melioidosis from TB.
- To improve diagnostic accuracy in regions with co-endemic diseases.
Main Methods:
- Retrospective analysis of 22 culture-proven melioidosis cases initially treated for TB.
- Evaluation of clinical presentation, laboratory findings, and epidemiological features.
- Focus on identifying parameters to differentiate melioidosis from tuberculosis.
Main Results:
- Eight cases mimicked pulmonary TB, with other presentations including arthritis, spondylitis, lymphadenitis, and splenic abscess.
- Fever was the primary symptom; all patients had elevated erythrocyte sedimentation rate (ESR).
- Neutrophilic leucocytosis (68.2%) and diabetes mellitus (90.9%) were common findings.
Conclusions:
- High fever, elevated ESR, and neutrophilic leucocytosis in diabetic patients warrant suspicion for melioidosis.
- This is crucial when initiating presumptive anti-tuberculosis treatment in endemic areas.
- Early suspicion can lead to appropriate melioidosis treatment, improving patient outcomes.
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