Spectrum of imaging findings in melioidosis

Area of Science:

• Medical Imaging
• Infectious Diseases
• Radiology

Background:

• Melioidosis is an infectious disease with significant incidence in endemic areas like Thailand and Singapore.
• It affects multiple organ systems, presenting a wide range of clinical and imaging characteristics.
• Risk factors include comorbidities like diabetes, renal failure, alcoholism, malignancy, and immunosuppression.

Purpose of the Study:

• To illustrate the diverse clinical and imaging findings of melioidosis across various organ systems.
• To emphasize the importance of high clinical suspicion in diagnosing melioidosis, particularly in at-risk populations.

Main Methods:

• Pictorial review of melioidosis cases from two centers in Thailand and Singapore.
• Analysis of clinical and imaging data (radiography, CT, ultrasonography, MRI) from affected patients.
• Correlation of imaging findings with organ system involvement.

Main Results:

• The lungs are the most commonly affected organs, showing consolidation, nodules, and abscesses on imaging.
• Multiple small abscesses in the liver and spleen are highly suggestive of visceral melioidosis.
• Musculoskeletal involvement (bone and soft tissue) is typically seen in disseminated disease.

Conclusions:

• Imaging findings of melioidosis are not specific but crucial for diagnosis when considered with clinical context.
• High index of clinical suspicion is essential, especially in patients from or traveling to endemic areas with risk factors.
• Multimodality imaging plays a key role in identifying and characterizing melioidosis across different organs.