Melioidosis – A Rare Cause of Neck Abscess in Immunocompromised
Article Sidebar
Main Article Content
Abstract
Introduction
Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a saprophytic bacterium found in soil and water. Though multiple abscesses are a common presentation of melioidosis, isolated neck abscess due to B. pseudomallei is extremely rare and it is more prevalent in immunocompromised people.
Case Report
A young woman with uncontrolled Type II diabetes presented with neck abscess. Abscess was drained and culture showed Burkholderia pseudomallei. Appropriate treatment was given, including 3 weeks of parenteral antibiotics and 3 months of oral prophylactic antibiotics to prevent relapses. Patient responded well to treatment.
Discussion
Increased awareness of opportunistic infections like melioidosis is essential in the present era as diabetes is emerging as a global pandemic. It clinically resembles tubercular neck abscess. Strong clinical suspicion, early intervention and long term antibiotics can cure the disease completely without relapse.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
White NJ. Melioidosis. Lancet 2003; 361:1715-22
Dance DA. Melioidosis as an emerging global problem. Acta Trop. 2000; 74:115-9
Currie BJ. Advances and remaining uncertainties in the epidemiology of Burkholderia pseudomallei and melioidosis. Trans R Soc Trop Med Hyg. 2008;102:225-7.
Stewart T, Engelthaler DM, Blaney DD, Tuanyok A, et al. Epidemiology and investigation of melioidosis, Southern Arizona. Emerg Infect Dis. 2011; 17:1286-8
Pagnarith Y, Kumar V, Thaipadungpanit J, Wuthiekanun V, et al. Emergence of pediatric melioidosis in Siem Reap, Cambodia. Am J Trop Med Hyg. 2010; 82:1106-12
Ralph A, McBride J, Currie BJ. Transmission of Burkholderia pseudomallei via breast milk in Northern Australia. Pediatr Infect Dis J. 2004; 23:1169-71
Raja NS. Localized melioidosis. J Pak Med Assoc. 2003; 53:373-4
Currie BJ, Ward L, Cheng AC. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis. 2010; 4:e900
Chantratita N, Wuthiekanun V, Limmathurotsakul D, Thanwisai A, et al. Prospective clinical evaluation of the accuracy of 16S rRNA real-time PCR assay for the diagnosis of melioidosis. Am J Trop Med Hyg. 2007; 77:814-7
Garas G, Ifeacho S, Millard R, Tolley N. Melioidosis and the vacuum-assisted closure device: a rare cause of a discharging neck wound, and a new approach to management. J Laryngol Otol. 2010;124(9):1021-4
Peacock SJ, Schweizer HP, Dance DA, Smith TL, et al. Management of accidental laboratory exposure to Burkholderia pseudomallei and B. mallei. Emerg Infect Dis. 2008; 14:e2.