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Updated: Aug 6, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Melioidosis in kidney transplant recipients: A report of two cases
Chilaka Rajesh1, Jessica Vaddeswarapu2, Utkarash Mishra1
1Department of Nephrology, Christian Medical College, Vellore, Tamilnadu, India.
Rationale:
Melioidosis is a serious opportunistic infection caused by Burkholderia (B.) pseudomallei, primarily affecting immunocompromised individuals, particularly in endemic regions. Timely diagnosis and appropriate treatment are crucial to prevent fatal outcomes.
Patient Concerns:
Case 1 was a 34-year-old male kidney transplant recipient who presented with a 15-day history of intermittent fever, accompanied by liver and spleen abscesses. Case 2 was a 37-year-old female kidney transplant recipient who presented with acute febrile illness and developed leucopenia. Blood cultures for both patients grew B. pseudomallei.
Diagnosis:
Both patients were diagnosed with melioidosis caused by B. pseudomallei, with the diagnosis confirmed through pus culture from the liver abscess in Case 1 and blood culture in Case 2.
Interventions:
Both patients were treated with an intensive regimen of meropenem (renal-adjusted doses), followed by a 3-month course of oral cotrimoxazole for eradication therapy.
Outcomes:
Case 1 experienced resolution of liver and spleen abscesses after 3 months of treatment and continued to recover well. In Case 2, blood cultures became sterile after 4 weeks, with no further complications observed.
Lessons:
Melioidosis should be suspected in immunocompromised patients, especially kidney transplant recipients, who present with unexplained fever and sepsis-like symptoms. Early diagnosis through aspiration of abscesses and prompt treatment are critical for preventing relapses and improving patient outcomes.
Insights
Melioidosis, a severe infection caused by Burkholderia pseudomallei, requires prompt diagnosis and treatment in immunocompromised patients. Early intervention in kidney transplant recipients with unexplained fever and sepsis-like symptoms is crucial for successful outcomes.
Area of Science:
- Infectious Diseases
- Microbiology
- Transplantation Immunology
Background:
- Melioidosis is a serious opportunistic infection caused by Burkholderia pseudomallei, predominantly affecting immunocompromised individuals in endemic areas.
- Prompt diagnosis and effective treatment are vital to prevent severe outcomes and mortality associated with melioidosis.
Purpose of the Study:
- To highlight the importance of suspecting melioidosis in immunocompromised patients, particularly kidney transplant recipients, presenting with unexplained fever and sepsis-like symptoms.
- To emphasize the critical role of early diagnosis and appropriate treatment in managing melioidosis and preventing relapses.
Main Methods:
- Two cases of kidney transplant recipients diagnosed with melioidosis caused by Burkholderia pseudomallei are presented.
- Diagnosis was confirmed via pus culture from liver abscess (Case 1) and blood culture (Case 2).
Main Results:
- Both patients received intensive meropenem therapy followed by oral cotrimoxazole.
- Case 1 showed resolution of abscesses after 3 months, while Case 2 achieved sterile blood cultures within 4 weeks with no further complications.
Conclusions:
- Melioidosis should be considered in immunocompromised patients, especially kidney transplant recipients, with unexplained fever and sepsis-like symptoms.
- Early diagnostic procedures like abscess aspiration and prompt, appropriate treatment are essential for improved patient outcomes and relapse prevention.
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