Surgical presentation of melioidosis in India.
BACKGROUND
Melioidosis, the disease caused by Burkholderia pseudomallei, is common in Southeast Asia. It has also been reported from India, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites.


METHODS
All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated.


RESULTS
Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed.


CONCLUSIONS
Melioidosis is under-diagnosed in India, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent.
Mathew
S
S
Christian Medical College, Vellore, Tamil Nadu, India.
Perakath
B
B
Mathew
G
G
Sitaram
V
V
Nair
A
A
Lalitha
M K
MK
John
T J
TJ
D000038:Abscess / Q000209:etiology* / Q000601:surgery; D000328:Adult; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008554:Melioidosis / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D013158:Splenic Diseases / Q000209:etiology / Q000601:surgery
D002511:Cephalosporins; D002442:Ceftazidime