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Chronic suppurative joint effusion due to burkholderia pseudomallei: a case report

Madhavi Deshmukh1, Shailendra Mundhada

  • 1Department of Microbiology, Dhruv Pathology and Molecular Diagnostic Laboratory, Nagpur, Maharashtra, India.

Indian Journal of Pathology & Microbiology
|January 21, 2014
PubMed

Insights

Melioidosis, caused by Burkholderia pseudomallei, is difficult to diagnose outside endemic areas. This case highlights the need for rapid identification systems for this rare but serious infection.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is a glanders-like disease primarily affecting animals, rarely seen in humans outside endemic regions.
  • Diagnosis of B. pseudomallei is challenging due to nonspecific clinical signs, limited awareness among clinicians and microbiologists in non-endemic areas, and specialized laboratory requirements.
  • Diabetes mellitus is a known risk factor for various infections, potentially increasing susceptibility to unusual pathogens.

Observation:

  • A case of chronic left hip joint effusion in a patient with diabetes mellitus was investigated.
  • Gram stain of CT-guided aspirate revealed Gram-negative bacilli and pus cells.
  • Automated Vitek2C system identified the pathogen as Burkholderia pseudomallei.

Findings:

  • The isolated Burkholderia pseudomallei demonstrated sensitivity to ceftazidime and trimethoprim/sulfamethoxazole.
  • The patient succumbed to severe septicemia due to delayed detection and treatment initiation.
  • The organism exhibited an unusual antibiogram, with disc diffusion methods not being standardized for its identification.

Implications:

  • This case underscores the critical importance of automated identification systems for B. pseudomallei in non-endemic regions.
  • Early and accurate diagnosis is crucial for timely antibiotic administration and improved patient outcomes in Melioidosis.
  • Awareness of B. pseudomallei's potential presentation and unusual antibiogram is vital for clinicians and microbiologists in non-endemic settings.

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