What is cheesier than a Whitmore’s liver? An accidental diagnosis of melioidosis

Harika Vangara; Jayaprada Rangineni; Venkata Rami Reddy Vutukuru; Sarala Settupalli; Bhavya Kotapati

doi:10.46475/asean-jr.v24i3.884

Authors

Harika Vangara , M.D. Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India. https://orcid.org/0009-0003-0254-9830
Jayaprada Rangineni, M.D. Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, A.P, India.
Venkata Rami Reddy Vutukuru, M.D. Department of Surgical Gastroenterology, Sri Venkateswara Institute of Medical Sciences, Tirupati, A.P, India.
Sarala Settupalli, M.D. Department of Radiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, A.P, India.
Bhavya Kotapati, B.Sc. ) Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, A.P, India.

DOI:

https://doi.org/10.46475/asean-jr.v24i3.884

Keywords:

Melioidosis, Liver abscess, Burkhloderia pseudomallei

Abstract

Despite the endemicity of Melioidosis in India, there were no official reports of the same case in our area which can be attributed to a lack of awareness of its occurrence in this geographic region, varied manifestations and consequent misdiagnosis. We report a case of Melioidosis from Tirupati, Andhra Pradesh. A diabetic male presented with fever, jaundice, and breathlessness. Radiological investigations revealed abscesses in the liver and spleen with a swiss cheese or honey comb appearance on CECT abdomen. The patient rapidly succumbed to the illness even with appropriate antibiotics in view of delayed presentation. Pus aspirated from the patient isolated Burkholderia species which was later confirmed through molecular methods as Burkhloderia pseudomallei. Hence, it is advised to consider Melioidosis as a potential infection in this region, for a timely and appropriate management of the patient’s conditions.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Mohapatra PR, Mishra B. Burden of melioidosis in India and South Asia: Challenges and ways forward. Lancet Reg Health Southeast Asia 2022;2:100004. doi: 10.1016/j.lansea.2022.03.004.

Koshy M. Melioidosis: an emerging infection in India. Curr Med Issues 2020;18:94-7.

Limmathurotsakul D, Golding N, Dance DA, Messina JP, Pigott DM, Moyes CL, et al. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 2016; 1:15008. doi: 10.1038/nmicrobiol.2015.8.

Savaj P, Shaw T, Munim FC, Mukhopadhyay C. Melioidosis in Gujarat: a neglected tropical disease. Trop Doct 2020;50:373-5. doi: 10.1177/0049475520928219.

Mukhopadhyay C, Shaw T, Varghese GM, Dance DAB. Melioidosis in South Asia (India, Nepal, Pakistan, Bhutan and Afghanistan). Trop Med Infect Dis 2018;3:51. doi: 10.3390/tropicalmed3020051.

Vinayan S, Bhat UP. Clinical, epidemiological and microbiological profile of a potentially pathogenic environmental saprophyte, Burkholderia pseudomallei; at a Tertiary Care Hospital in Coastal India. J Pure Appl Microbiol 2022;16:193-200.

Selvam K, Ganapathy T, Najib MA, Khalid MF, Abdullah NA, Harun A, et al. Burden and risk factors of melioidosis in Southeast Asia: a scoping review. Int J Environ Res Public Health 2022;19:15475. doi: 10.3390/ijerph192315475.

Wiersinga WJ, Virk HS, Torres AG, Currie BJ, Peacock SJ, Dance DAB, et al. Melioidosis. Nat Rev Dis Primers 2018;4:17107. doi: 10.1038/nrdp.2017.107.

Burivong W, Wu X, Saenkote W, Stern EJ. Thoracic radiologic manifestations of melioidosis. Curr Probl Diagn Radiol 2012;41:199-209. doi: 10.1067/j.cpradiol.2012.01.001.

Harsha M, Tirlangi PK, Varma M, Mukhopadhyay C. Dealing with the honey trap: a case of hepatic melioidosis. QJM 2023; Jul 18:hcad175. doi: 10.1093/qjmed/hcad175.

Dance D. Treatment and prophylaxis of melioidosis. Int J Antimicrob Agents 2014;43:310-8. doi: 10.1016/j.ijantimicag.2014.01.005.