Splenic abscesses in a returning traveler

Abstract

Burkholderia, an aerobic gram-negative rod, is the causative organism behind melioidosis and is a common soil and water organism found predominantly in South-East Asia. We report the case of a 68 year-old man returning from an extended trip to the Philippines, with splenic hypodense lesions on abdominal computer tomography scan, later confirmed to be culture-positive for Burkholderia pseudomallei. The patient was treated with a course of intravenous ceftazidime followed by eradication therapy with oral doxycycline and trimethoprim-sulfamethoxazole. He recovered with complete resolution of symptoms at follow up. In a returning traveler from an endemic area, melioidosis should be considered as part of the differential for any febrile illness with abscesses.

Melioidosis: A Rare Cause of Liver Abscess

“…There is limited knowledge about the current disease epidemiology in Philippines. Reports are scarce and most of the patients were foreign travelers who visited the country and later on their return were found to be infected with the disease [ 12 – 14 ]. This suggests that underreporting in the country is highly plausible and that unavailability of capacitated laboratories for diagnosis is not widely accessible.…”

“…This suggests that underreporting in the country is highly plausible and that unavailability of capacitated laboratories for diagnosis is not widely accessible. Geographical location is not explicitly cited; however, some of these mentioned cases are from the provinces of Quezon [ 14 ] and Bulacan [ 15 ] and even in Manila [ 13 ]. Agricultural areas where rice is being cultivated are known to be an endemic place for the disease.…”

“…Agricultural areas where rice is being cultivated are known to be an endemic place for the disease. Rates were also reported in these places to be higher during monsoon and rainy season probably due to rising of water table percolating the organism [ 14 ].…”