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Melioidosis: An Emerging Infection with Fatal Outcomes
Isabella Princess1, R Ebenezer2, Nagarajan Ramakrishnan3
1Department of Microbiology, Apollo Speciality Hospitals, Vanagaram, Tamil Nadu, India.
Abstract:
According to the Centers for Disease Control and Prevention, from being nonendemic for melioidosis, India has now become endemic for the disease since 2012. Until then, melioidosis cases were being reported sporadically from India. There have been isolated case reports from few states across the country for the past few years. Most of the times, Burkholderia pseudomallei may be misreported as Pseudomonas species, especially in resource-poor laboratories. Due to its varied clinical presentation, the specific clinical diagnosis can be difficult, thereby making laboratory diagnosis mandatory. This could make a huge impact on patient care as this organism has a different treatment protocol as well as virulence determinants which influence the course of management. Although known for its endemicity in Australia, Thailand, and other Southeast Asian countries, B. pseudomallei has emerged in new areas such as India, Southern China, Brazil, and Malawi. We present a rare case of melioidosis with rapid disease progression to fatal outcome from Chennai, South India.
Insights
India is now endemic for melioidosis, a disease caused by Burkholderia pseudomallei. This rare case highlights the challenges in diagnosing and managing this serious infection, emphasizing the need for accurate laboratory identification.
Area of Science:
- Infectious Diseases
- Microbiology
Background:
- Melioidosis, caused by Burkholderia pseudomallei, is a significant emerging infectious disease.
- India transitioned from non-endemic to endemic status for melioidosis in 2012.
- Sporadic cases and isolated reports of melioidosis have been documented across India.
Observation:
- Burkholderia pseudomallei is often misidentified as Pseudomonas species in resource-limited settings.
- The diverse clinical manifestations of melioidosis pose diagnostic challenges.
- Rapid progression to a fatal outcome was observed in a rare case from South India.
Findings:
- Accurate laboratory diagnosis is crucial for effective melioidosis management.
- Misidentification can lead to inappropriate treatment due to differing therapeutic protocols.
- The emergence of B. pseudomallei in new regions like India necessitates increased awareness.
Implications:
- Enhanced diagnostic capabilities are vital for timely and appropriate patient care.
- Understanding the unique virulence factors of B. pseudomallei is essential for treatment strategies.
- Public health initiatives are needed to address the growing burden of melioidosis in endemic and newly affected areas.
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