Chronic melioidosis presenting with multiple abscesses.
Melioidosis is common in Australia and Southeast Asia and is increasingly recognized in India. It presents in various forms which are difficult to identify and often mimics suppurative infections, tuberculosis, fungal infections, malignancy and systemic rheumatic diseases. Presentation may vary from local disease to disseminated abscesses, pneumonia and sepsis. Disease is common and severe in diabetics. We describe a case of diabetic man presenting with fever, septic shock, peri-articular nodules, lung opacities and multiple abscesses in muscles for the past 3 months remaining undiagnosed. Autoimmune conditions were ruled out and infection withBurkholderia pseudomalleiwas suspected.Burkholderia pseudomalleiwas isolated from blood cultures, confirming the diagnosis. Prolonged treatment with intravenous ceftazidime followed by oral cotrimoxazole led to complete recovery. Awareness of this infection is required by clinicians and microbiologists unfamiliar with the condition to diagnose the disease early to prevent mortality.
Department of Rheumatology , Fortis Flt Lt Rajan Dhall Hospital , New Delhi , India.
Anshul
A
Goel
Department of Rheumatology , Fortis Flt Lt Rajan Dhall Hospital , New Delhi , India.
Rahul
R
Bansal
Department of Microbiology , Fortis Flt Lt Rajan Dhall Hospital , New Delhi , India.
Shweta
S
Sharma
Department of Radiology , Fortis Flt Lt Rajan Dhall Hospital , New Delhi , India.
Suman
S
Singhal
Department of Rheumatology , Fortis Flt Lt Rajan Dhall Hospital , New Delhi , India.
Ashok
A
Kumar