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Melioidosis presenting as lymphadenitis: a case report.

Sanjeewa Wijekoon¹, Thushanthy Prasath, Enoka M Corea

¹University Medical Unit, Colombo South Teaching Hospital, Kalubowila, Sri Lanka. sanjeewa_wijekoon@yahoo.co.uk.

BMC Research Notes

|June 15, 2014

Summary

Melioidosis, a serious bacterial infection, is emerging in South Asia. Early diagnosis and prompt treatment of this Burkholderia pseudomallei infection, especially in diabetic patients, lead to excellent outcomes.

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Area of Science:

Medical Microbiology
Infectious Diseases
Clinical Medicine

Background:

Melioidosis is caused by Burkholderia pseudomallei, a gram-negative bacterium.
Increasing cases of melioidosis with high morbidity and mortality are reported in Sri Lanka.
The infection presents with diverse clinical manifestations and varied prognoses.

Observation:

A 53-year-old diabetic woman presented with fever and painful inguinal lymphadenitis.
Initial pus cultures were misidentified as Pseudomonas sp. and Escherichia coli.
Polymerase chain reaction and antibody tests confirmed Burkholderia pseudomallei.

Findings:

The patient received intravenous ceftazidime followed by eradication therapy.
Antibiotic regimen was adjusted due to intolerance, with a good outcome.

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The patient recovered well with no relapse after six months.

Implications:

Melioidosis is an emerging infection in South Asia, often presenting with recurrent abscesses.
Accurate microbiological identification is crucial, as isolates may be misidentified.
Suspecting melioidosis in diabetic patients with specific antibiotic sensitivity patterns aids prompt diagnosis and treatment.