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Case Reports
. 2021 Jan 29;13(1):52-55.
doi: 10.4103/jgid.jgid_129_20. eCollection 2021 Jan-Mar.

Unusual Presentations of Abdominal Melioidosis

Vignesh Kumar Mohan  1 , Komalavalli Rajesh  1 , Sripriya Srinivas  1 , R Ravi  2 , Jimmy Prabhakaran  3 , K Srinivasan  1 , Subha Sundaramoorthy  4
Affiliations
Case Reports

Unusual Presentations of Abdominal Melioidosis

Vignesh Kumar Mohan et al. J Glob Infect Dis. .

Abstract

Melioidosis is an endemic bacterial infection caused by soil saprophyte, Burkholderia pseudomallei. It infects adults with risk factors or immunosuppressed and exposed to moist soil. Its significance lies in its varied clinical presentation and high mortality (40%). We present two cases of abdominal melioidosis with unusual clinical presentations. The first case presented with intractable hiccups and had isolated splenic melioidosis with contained rupture. The second case presented with fever and acute abdominal pain found to have pancreatic melioidosis and splenic vein thrombosis. Both the patients were treated with IV antibiotics and subsequently discharged after improvement in symptoms. The imaging findings of isolated type of melioidosis can mimic various other infections and granulomatous disease. Hence high index of clinical suspicion for patients presenting from endemic areas will narrow down the differential diagnosis.

Keywords: Burkholderia infection; melioidosis; splenic abscess.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a-c) Contrast-enhanced computed tomography abdomen, coronal section showing (a) multiple, tiny hypodense splenic lesions (thin arrow) with clustered pattern of distribution in subcapsular location and perisplenic extension (curved arrow). Magnetic resonance imaging abdomen, axial section showing T2-weighted image (b) and diffusion-weighted imaging (c) showing multiple T2 hyperintense lesions with diffusion restriction in the spleen
Figure 2
Figure 2
(a-c) Contrast-enhanced computed tomography abdomen, coronal section showing (a) heterogeneous hypoenhancement in the tail of the pancreas (arrow). (b) Nonenhancing thrombus involving the splenic vein (thick arrow) from the confluence till the intraparenchymal branches with enhancing thickened wall of the splenic vein (thin arrow). (c) Magnetic resonance imaging abdomen, axial section showing diffusion restriction with corresponding low apparent diffusion coefficient in the distal body of the pancreas and in the splenic vein thrombus
Figure 3
Figure 3
(a and b) Bacterial colony morphology of pus and blood culture. (a) MacConkey agar showing typical nonlactose-fermenting, metallic sheen appearing colonies. (b) Gram smear revealing characteristic bipolar Gram-negative bacilli (×100)
See this image and copyright information in PMC

References

    1. Whitemore A, Krishnaswami CS. An account of the discovery of a hitherto undescribed infective disease occurring among the population of Rangoon. Indian Med Gaz. 1912;47:262–7. - PMC - PubMed
    1. Chen H, Hu ZQ, Fang Y, Lu XX, Li LD, Li YL, et al. A case report: Splenic abscess caused by Burkholderia pseudomallei. Medicine (Baltimore) 2018;97:e11208. - PMC - PubMed
    1. Lim KS, Chong VH. Radiological manifestations of melioidosis. Clin Radiol. 2010;65:66–72. - PubMed
    1. Noah DL, Huebner KD, Darling RG, Waeckerle JF. The history and threat of biological warfare and terrorism. Emerg Med Clin North Am. 2002;20:255–71. - PubMed
    1. Gopalakrishnan R, Sureshkumar D, Thirunarayan MA, Ramasubramanian V. Melioidosis: An emerging infection in India. J Assoc Physicians India. 2013;61:612–4. - PubMed

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