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Brainstem micro-abscesses caused by Burkholderia pseudomallei in a 10-month-old infant: a case report

M Prasanna Kumar1, Sriram Krishnamurthy1, V S Venkateswaran1

  • 1a Department of Paediatrics , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.

Paediatrics and International Child Health
|July 5, 2016
PubMed

Insights

Melioidosis, a tropical disease caused by Burkholderia pseudomallei, rarely affects infants neurologically. This case highlights a 10-month-old with disseminated melioidosis and neurological complications, successfully treated with antibiotics.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Pediatrics

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is an uncommon tropical infectious disease.
  • Neurological complications are exceptionally rare in infants with melioidosis.

Observation:

  • A 10-month-old infant presented with disseminated melioidosis, including subcutaneous nodules, arthritis, hepatomegaly, and a lung cavity.
  • The infant developed a left medial rectus palsy, indicating cranial nerve involvement.
  • Cranial MRI revealed micro-abscesses in the mid-brain, pons, and basal ganglia.

Findings:

  • Treatment with meropenem and cotrimoxazole resulted in the resolution of the medial rectus palsy.
  • The infant experienced no residual neurological deficits at a 5-month follow-up.

Implications:

  • This case underscores the possibility of rare neurological manifestations of melioidosis in infants.
  • Prompt diagnosis and appropriate antibiotic therapy are crucial for favorable outcomes in pediatric melioidosis with neurological involvement.
  • Further research may elucidate the specific mechanisms of neuro-melioidosis in young children.
Keywords:
Brainstem micro-abscessesBurkholderia pseudomalleiInfantMelioidosisNeuromelioidosis

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