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Melioidosis of the Head and Neck: A Case Series from Eastern India
Srujana Mohanty1, Saurav Sarkar2, Baijayantimala Mishra1
1Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India.
Abstract:
Melioidosis is an emerging entity in India. Though it is a potentially fatal disease, prognosis is excellent with early detection and appropriate management, especially of localized infections like abscesses of the head and neck area. We report nine cases of focal abscesses in the head and neck region due to Burkholderia pseudomallei, the causative agent of melioidosis, presenting to our hospital within a span of two-and-half years. Since melioidotic abscesses in the cervicofacial and head and neck region are likely to be confused with cold abscesses caused by Mycobacterium tuberculosis in a tuberculosis-endemic country like India, increased vigilance is necessary because of the widely divergent treatment modalities of the two disease entities.
Insights
Melioidosis, caused by Burkholderia pseudomallei, is emerging in India. Early detection and treatment of head and neck abscesses are crucial for excellent prognosis, distinguishing it from tuberculosis.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Melioidosis is an emerging infectious disease in India, caused by Burkholderia pseudomallei.
- Prompt diagnosis and management are vital for a favorable prognosis, particularly for localized infections.
- Head and neck abscesses present a diagnostic challenge due to similarities with other conditions.
Observation:
- Nine cases of focal head and neck abscesses due to Burkholderia pseudomallei were observed over 2.5 years.
- These cervicofacial abscesses mimicked cold abscesses typically caused by Mycobacterium tuberculosis.
- India's high tuberculosis prevalence complicates the differential diagnosis.
Findings:
- Burkholderia pseudomallei is a significant cause of head and neck abscesses in India.
- Melioidotic abscesses require specific antibiotic treatment, differing from tuberculosis management.
- Misdiagnosis can lead to inappropriate treatment and poorer patient outcomes.
Implications:
- Increased vigilance for melioidosis is necessary in India, especially for head and neck abscesses.
- Distinguishing melioidosis from tuberculosis is critical due to divergent treatment protocols.
- Enhanced diagnostic awareness can improve patient outcomes for this emerging infectious disease.
