Melioidosis: an uncommon cause of neck abscess.
BACKGROUND
Melioidosis is a life-threatening disease caused by B. pseudomallei. It is endemic in Southeast Asia with a few reports from the Western world. It is transmitted via inhalation, ingestion or direct contact with an open wound. Clinically it may present with local or systemic symptoms. Mortality rate is very high in systemic disease; but local infection is usually mild, which causes delay in seeking medical attention.


METHODS
We report a case of neck melioidosis presenting as a parapharyngeal abscess that was successfully managed with incision and drainage and intravenous ceftazidime and co-trimoxazole for 6 weeks followed by eradication therapy with oral co amoxiclav.


CONCLUSIONS
Neck melioidosis must be considered one of differential diagnoses for "cold abscesses" of the neck, especially in an endemic area, in Asian migrants, or in those with history of previous visit from the endemic regions.
Department of Otolaryngology, University Malaya Medical Center, University Malaya, Kuala Lumpur. ab_zulkiflee@yahoo.com
Abu Bakar
AB
Zulkiflee
Narayanan
N
Prepageran
Rajan
R
Philip
D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016957:Burkholderia pseudomallei / Q000302:isolation & purification; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008554:Melioidosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents