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Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis

Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis

Published on: February 24, 2023

False-positive widal in melioidosis.

Rohith Valsalan¹, S Shubha, C Mukhopadhyay

¹Department of Medicine, Kasturba Medical College, Manipal, India. drrohithv@gmail.com

Indian Journal of Medical Sciences

|November 11, 2009

Summary

High Widal titers can misdiagnose melioidosis, an emerging disease. Microbiological testing is crucial for accurate diagnosis, especially when patients show poor response to initial treatment for enteric fever.

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Identification of Rare Bacterial Pathogens by 16S rRNA Gene Sequencing and MALDI-TOF MS

Identification of Rare Bacterial Pathogens by 16S rRNA Gene Sequencing and MALDI-TOF MS

Published on: July 11, 2016

Area of Science:

Medical Microbiology
Infectious Diseases
Clinical Diagnostics

Background:

Enteric fever diagnosis often relies on the Widal test, a long-standing method in endemic regions.
Melioidosis, caused by Burkholderia pseudomallei, is an emerging infectious disease in the region, frequently misdiagnosed.
False-positive Widal reactions are known to occur with non-typhoid Salmonella infections.

Observation:

Three cases presented with high Widal titers, initially suggesting enteric fever.
Melioidosis was the actual diagnosis in all three cases, unrecognized until microbiological confirmation.
Patients showed only partial response to ceftriaxone treatment.

Findings:

Blood and pus cultures confirmed Burkholderia pseudomallei in all patients.
Salmonella typhi was not isolated from blood cultures in any of the cases.
Treatment with appropriate antibiotics led to clinical and microbiological improvement, with decreasing Widal titers.

Implications:

High Widal titers can be misleading, potentially masking melioidosis diagnoses.
Further laboratory investigations are essential to rule out melioidosis in patients with high Widal titers, particularly those unresponsive to treatment.
This highlights the importance of considering emerging infectious diseases in differential diagnoses, even with seemingly indicative serological results.