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Melioidosis presenting as pseudomyxoma peritonei: yet another pretense of the great mimicker: an unreported entity
Raghavan Velayutham Sugi Subramaniam1, Vilvapathy Senguttuvan Karthikeyan, Sarath Chandra Sistla
1Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Background:
Melioidosis, a lethal infectious disease caused by Burkholderia pseudomallei, an important human pathogen in tropical regions, is notorious for its diverse clinical presentations.
Methods:
We report a case of a 55-year-old woman with a history of total abdominal hysterectomy with bilateral salpingo-oophorectomy for ovarian mucinous cystadenocarcinoma five years back, who presented with complaints of chest pain, abdominal distention, and breathlessness for one week. Ultrasound-guided aspiration of the peritoneal free fluid revealed a thick gelatinous material consistent with pseudomyxoma peritonei. Cytologic analysis of the aspirate was negative for malignant cells, but bacterial culture proved positive for Burkholderia pseudomallei.
Results:
She was started on ceftazidime, and she improved symptomatically and was discharged on oral doxycycline and chloramphenicol after three weeks of intravenous antibiotic therapy.
Conclusion:
This case is being reported to emphasize an unusual presentation of melioidosis and the significance of timely appropriate antibiotic therapy.
Insights
Melioidosis, a bacterial infection caused by Burkholderia pseudomallei, can present unusually. Early antibiotic treatment is crucial for recovery from this severe disease.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Case Reports
Background:
- Melioidosis is a severe infectious disease caused by Burkholderia pseudomallei, a significant pathogen in tropical areas.
- The disease is known for its wide range of clinical manifestations.
- Burkholderia pseudomallei is a Gram-negative bacterium found in soil and water.
Observation:
- A 55-year-old woman presented with chest pain, abdominal distention, and breathlessness.
- She had a history of hysterectomy for ovarian cystadenocarcinoma.
- Ultrasound-guided fluid aspiration revealed pseudomyxoma peritonei, with bacterial cultures positive for Burkholderia pseudomallei.
Findings:
- Cytologic analysis of the peritoneal fluid was negative for malignancy.
- The patient was treated with intravenous ceftazidime, followed by oral doxycycline and chloramphenicol.
- She showed symptomatic improvement and was discharged after three weeks.
Implications:
- This case highlights an atypical presentation of melioidosis.
- It underscores the importance of considering infectious etiologies in patients with unusual symptoms.
- Prompt and appropriate antibiotic therapy is vital for successful melioidosis management.
