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Cutaneous Melioidosis Presenting as a Red Nasal Plaque: A Case Report
Sarocha Huang1, Pitak Santanirand2, Suwichak Chairanaicharoen2
1Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Background:
Melioidosis, caused by Burkholderia pseudomallei, is endemic to tropical regions. Cutaneous forms, often presenting as non-healing ulcers, are rare and may mimic other skin diseases. Recognizing risk factors is key to prompt diagnosis and treatment.
Case Presentation:
We report the case of a 51-year-old female with a 2-month history of chronic erythematous plaques on her nose. Aerobic tissue culture confirmed the diagnosis of primary cutaneous melioidosis by identifying B. pseudomallei. There was no evidence of systemic involvement, and blood culture results were negative. The patient was successfully treated with oral sulfamethoxazole-trimethoprim monotherapy. After three months of treatment, the lesion resolved completely, leaving an atrophic scar. At the eight-month follow-up, there was no evidence of recurrence.
Conclusion:
This case illustrates an atypical presentation of cutaneous melioidosis without systemic involvement, which was effectively treated with oral sulfamethoxazole-trimethoprim monotherapy. A comprehensive evaluation to exclude dissemination is critical for ensuring successful treatment outcomes.
Insights
Primary cutaneous melioidosis, caused by Burkholderia pseudomallei, can present atypically. This case highlights successful treatment of a non-healing nasal lesion with sulfamethoxazole-trimethoprim.
Area of Science:
- Infectious Diseases
- Dermatology
- Microbiology
Background:
- Melioidosis, a tropical disease caused by Burkholderia pseudomallei, often manifests as non-healing ulcers.
- Cutaneous melioidosis is rare and can mimic other dermatological conditions, necessitating awareness of risk factors for early diagnosis.
Observation:
- A 51-year-old female presented with a two-month history of chronic, erythematous plaques on her nose.
- Initial presentation mimicked other skin conditions, delaying diagnosis.
Findings:
- Aerobic tissue culture confirmed primary cutaneous melioidosis due to Burkholderia pseudomallei.
- The patient had no systemic involvement, with negative blood cultures.
- Complete resolution of the nasal lesion was achieved after three months of oral sulfamethoxazole-trimethoprim monotherapy.
Implications:
- This case underscores the importance of considering melioidosis in the differential diagnosis of chronic skin lesions, especially in endemic areas.
- Effective treatment of primary cutaneous melioidosis without systemic involvement is achievable with oral antibiotics.
- Comprehensive evaluation to rule out systemic dissemination is crucial for successful patient outcomes.
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