Primary cutaneous melioidosis - A rare case needing intensive care unit admission

Melioidosis cases are increasing in Southeast Asia, posing a significant challenge owing to the rising number of diabetic and immune compromised patients. Pneumonia is the most common presentation of melioidosis, while cutaneous melioidosis is rare.

We report a case of primary cutaneous melioidosis (PCM) that eventually required intensive care unit (ICU) management.

We describe the case of a 33-year-old male with uncontrolled diabetes mellitus who initially presented with a skin lesion, which was followed by gradual multiorgan involvement diagnosed as melioidosis based on culture-positive results from blood and synovial fluid, and needed ICU admission.

He was successfully treated with intravenous antibiotics and invasive mechanical ventilation after ICU admission.

Cutaneous melioidosis can lead to ICU admission and, if untreated, has a high fatality rate. Faster diagnostic methods like VITEK 2 Compact and MALDI TOF substantially reduce delays in initiating required treatment.

Our study emphasize on the need of considering Meliodosis as a possible differential diagnosis, as in lower middle income countries (LMIC) where it can be a frequent cause of multiorgan involvement due to tropical environment and diagnostic resource limitations.