title: Melioidosis, the great mimicker: a report of 10 cases from Malaysia.
abstract: Between 1981 and 1986, 10 consecutive cases of melioidosis were seen at the University Hospital, Kuala Lumpur, Malaysia. They illustrate the amazing guises of melioidosis presenting as: abscesses of the supraspinatus muscle, psoas muscle, brain and liver; three different pulmonary forms; an acute suppurative dermal lesion; an acute septicaemia; and chronic lymphadenitis. The majority had underlying diseases: diabetes mellitus, the commonest, was present in six, out of whom three had previous pulmonary tuberculosis; other predisposing conditions were renal failure, corticosteroid therapy and malnutrition. Three patients who died had pre-existing renal impairment and developed renal failure later, suggesting that the former is a bad prognostic sign. Clinical diagnosis was difficult: all cases were diagnosed bacteriologically. A high level of clinical awareness is necessary, especially when presentation simulates pulmonary or extrapulmonary tuberculosis in patients with diabetes or other compromised states.
authors.affiliation: Department of Medicine, University of Malaya, Kuala Lumpur.
authors.forename: K C
authors.initials: KC
authors.lastname: Yee
authors.forename: M K
authors.initials: MK
authors.lastname: Lee
authors.forename: C T
authors.initials: CT
authors.lastname: Chua
authors.forename: S D
authors.initials: SD
authors.lastname: Puthucheary
mesh_terms: D000038:Abscess; D000293:Adolescent; D000328:Adult; D000368:Aged; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008169:Lung Abscess; D008296:Malaysia; D008297:Male; D008554:Melioidosis; D008875:Middle Aged; D009135:Muscular Diseases