CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2018; 08(03): 034-036
DOI: 10.1055/s-0040-1708761
Case Report

A Case Report of Meilodosis

Satheesh Kumar Bhandary
1   Vice chancellor, Nitte (deemed to be University) & Professor, Department of ENT, K S Hegde Medical Academy, Mangalore
,
Ivan Paraekulam Mani
2   Post Graduate Student, Department of ENT, K S Hegde Medical Academy, Mangalore
,
Rajeshwary Aroor
3   Professor & Head, Department of ENT, K S Hegde Medical Academy, Mangalore
,
Vadisha Bhat
4   Professor, Department of ENT, K S Hegde Medical Academy, Mangalore.
› Author Affiliations

Abstract

Meilodosis is an infection caused by a gram negative bacterium, Burkholderia pseudomallei associated with high fatality rates. This organism is a widely distributed environmental saprophyte found in soil and stagnant water in the endemic regions of south East Asia and 1 Australia. It was first diagnosed in Burma by Captain Alfred Whitmore, and his assistant, C.S. 2 Krishnaswami in 1911. Meilodosis is an emerging pathogen in South India predominantly due to negligent management and a delayed diagnosis.

The majority of the cases of B. pseudomallei infections are subclinicalwith the primary modality of transmission being through broken skin. The disease predominantly manifests in individuals 3 with diabetes mellitus, chronic renal disease and alcoholism. The majority of patients present 4 with pyrexia and localized skin ulcerations or abscesses. There is a high incidence of 5 pneumonia and septic shock following contamination. Transmission from a patient by droplet 6 spread is rare even with the presence of pulmonary melioidosis. Meliodosis of the head and neck region is not common, however it accounts for 40% of the cases of supportive parotitis in 7 children in Thailand and Cambodia. Diagnosis can be challenging due to its close symptomatic resemblance to tuberculosis. Isolation of the organism is difficult; this leads to poor identification of the causative agent and mismanagement.



Publication History

Received: 02 March 2018

Accepted: 31 July 2018

Article published online:
21 April 2020

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  • References

  • 1 Dance DAB, Smith MD, Aucken HM, Pitt TL. Imported melioidosis in England and Wales. Lancet 1999; 353:208–9
  • 2 John TJ, Jesudason MV, Lalitha MK, Ganesh A, Mohandas V, Cherian T et al. Melioidosis in India: the tip of the iceberg? Indian J Med Res 1996;103:62–5
  • 3 Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. ClinMicrobiol Rev 2005; 18:38–41 6 Jesudason M
  • 4 White NJ. Melioidosis. Lancet 2003;361:1715–22
  • 5 Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. ClinMicrobiol Rev 2005; 18:383.
  • 6 Currie BJ, Dance DA, Cheng AC. The global distribution of Burkholderia pseudomallei and melioidosis: an update. Trans R Soc Trop Med Hyg 2008; 102 Suppl 1:S1.
  • 7 Chaowagul W, White NJ, Dance DA, et al. Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. J Infect Dis 1989; 159:890.
  • 8 Currie BJ, Fisher DA, Howard DM, et al. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop 2000; 74:121.
  • 9 Currie BJ, Fisher DA, Howard DM, et al. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop 2000; 74:121.
  • 10 Leelarasamee A, Bovornkitti S. Melioidosis: review and update. Rev Infect Dis 1989; 11:413.
  • 11 Kunakorn M, Jayanetra P, Tanphaichitra D. Man-to-man transmission of melioidosis. Lancet 1991; 337:1290.
  • 12 Ralph A, McBride J, Currie BJ. Transmission of Burkholderia pseudomallei via breast milk in northern Australia. Pediatr Infect Dis J 2004; 23:1169.
  • 13 Chaowagul W, White NJ, Dance DA, et al. Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. J Infect Dis 1989; 159:890.
  • 14 Suputtamongkol Y, Chaowagul W, Chetchotisakd P, et al. Risk factors for melioidosis and bacteremicmelioidosis. Clin Infect Dis 1999; 29:408.
  • 15 Currie BJ, Jacups SP, Cheng AC, et al. Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia. Trop Med Int Health 2004; 9:1167.
  • 16 Currie BJ, Ward L, Cheng AC. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoSNegl Trop Dis 2010; 4:e900.
  • 17 McLeod C, Morris PS, Bauert PA, et al. Clinical presentation and medical management of melioidosis in children: a 24-year prospective study in the Northern Territory of Australia and review of the literature. Clin Infect Dis 2015; 60:21.
  • 18 Dance DA, Davis TM, Wattanagoon Y, et al. Acute suppurativeparotitis caused by Pseudomonas pseudomallei in children. J Infect Dis 1989; 159:654.
  • 19 Lumbiganon P, Viengnondha S. Clinical manifestations of melioidosis in children. Pediatr Infect Dis J 1995; 14:136
  • 20 Gibney KB, Cheng AC, Currie BJ. Cutaneous melioidosis in the tropical top end of Australia: a prospective study and review of the literature. Clin Infect Dis 2008; 47:603.
  • 21 Limmathurotsakul D, Kanoksil M, Wuthiekanun V, et al. Activities of daily living associated with acquisition of melioidosis in northeast Thailand: a matched case-control study. PLoSNegl Trop Dis 2013; 7:e2072.
  • 22 Jesudason MV, Anbarasu A, John TJ. Septicaemicmeliodosis in a tertiary care hospital in south India. Indian J Med Res 2003;117:119–21