Melioidosis: An under-diagnosed entity in western coastal India: A clinico-microbiological analysis

Abstract

Clinico-microbiological analysis of a series of 25 patients with culture proven melioidosis was done. All patients came from the coastal regions of Kerala and Karnataka and presented between June 2005 to July 2006. They were analysed with respect to clinical presentation, occupation, epidemiology and microbiological features. No single presenting clinical feature was found to be typical of melioidosis. The disease was found to mimic a variety of conditions, including tuberculosis and malignancy. Burkholderia pseudomallei was isolated from blood, sputum, pus, urine, synovial, peritoneal and pericardial ß uids. Diabetes mellitus was the most common predisposing factor and 80% of the cases presented during the Southwest monsoon (June to September). It is probable that melioidosis is highly prevalent in western coastal India and yet, greatly underestimated. Better awareness, both among clinicians and microbiologists, coupled with improved diagnostic methods to allow early diagnosis and hence early treatment, will signiÞ cantly reduce the morbidity and mortality associated with this disease.

Melioidosis Presenting as Fever and Jaundice: A Rare Presentation

“…8 Although healthy people may get melioidosis, the major risk factors include diabetes (present in 23-60% of patients), heavy alcohol use (in 12-39%), chronic pulmonary disease (in 12-27%), chronic renal disease (in 10-27%), thalassemia (in 7%), glucocorticoid therapy (in <5%), and cancer (in <5%). 9 In an Indian series by Vidyalakshmi et al 10 predisposing factors were present in all the patients, of which the commonest was diabetes mellitus, which was present in 76% of the patients. The other predisposing conditions in this series included renal disease, steroid therapy and malnutrition, alcohol abuse, and chronic lung disease.…”

Melioidosis Bacteremia: A Post Flood Disaster Case Report

“…of contaminated dust and direct entry of the organism into blood stream via very minor wounds or skin abrasions [4]. Other modes of transmission are aspiration and ingestion of contaminated water.…”

“…In our patient diabetes was an incidental finding during the course of investigation. Vidyalaxmi et al [4] found a correlation of 76% of diabetes with Melioidosis. Two commonest modes of transmission are inhalation BD.…”

PUO with multiple abscesses due to Burkholderia pseudomallei: a case report

“…4 One case of cellulitis of neck with septicemia was reported. 3 Fever with multiple abscesses with underlying osteomyelitis is rare.…”

“…2 Sporadic cases of melioidosis from various parts of South India 3 and Western costal India have been reported, but remained underdiagnosed due to lack of awareness. 4 …”