Melioidosis presenting as isolated pericardial effusion

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• A diabetic fisherman presented with symptoms suggestive of pericarditis.
• Initial suspicion of tuberculous pericarditis due to elevated adenosine deaminase in pericardial fluid.
• Echocardiography confirmed a large pericardial effusion.

Purpose of the Study:

• To report a case of melioidosis presenting as isolated pericardial effusion.
• To highlight the importance of microbiological diagnosis in pericardial effusions.
• To emphasize that melioidosis can occur without an obvious primary infection site.

Main Methods:

• Case report of a patient with pericardial effusion.
• Analysis of pericardial fluid for adenosine deaminase levels.
• Isolation of Burkholderia pseudomallei from pericardial fluid culture.

Main Results:

• Tuberculous pericarditis was initially suspected but ruled out.
• Melioidosis was confirmed by bacterial culture of pericardial fluid.
• The patient experienced recurrence of effusion due to incomplete treatment.

Conclusions:

• Microbiological confirmation is essential to differentiate melioidosis from tuberculosis in pericardial effusions.
• Melioidosis should be considered in the differential diagnosis of pericardial effusion, even without a clear source.
• Prompt and complete antibiotic therapy is vital for successful melioidosis treatment.