| dc.description.abstract | Melioidosis causes suppurative infection with local abscesses and the reservoirs of the organism;
Burkholderia pseudomallei are soil, fresh water and paddy fields. The diagnosis is made by
isolating the organism through culture and microscopy. Treatment includes an intensive course
of intravenous and oral antibiotics which spans over 3 months. A 62-year-old patient from
Kurunegala, with a background history of diabetes mellitus, hypertension, dyslipidaemia,
presented with left lower limb pain and ankle swelling for 6 weeks’ duration. He was previously
treated with methotrexate for chronic plaque psoriasis. The cause for was diagnosed as occlusive
arterial disease and deep vein thrombosis of left lower limb and the treatment was started
accordingly. During the hospital stay, he developed septic shock with several episodes of diarrhea
and underwent septic screening. His blood culture was positive for Burkholderia and was
confirmed with serological assessment done at Faculty of Medicine, University of Colombo. The
patient had worked in paddy fields 6 months prior to this presentation. Following the diagnosis
through multi-disciplinary approach, the targeted treatment was started with intravenous
ceftazidime and oral metronidazole. Although the patient showed some response to initial
treatment, he succumbed to the illness due to the complications of his underlying comorbidities.
In conclusion, active melioidosis during immunocompromised states can cause a severe infection,
and it is crucial to have a clinical suspicion in relation to the epidemiology and clinical course of
the infection while managing the underlying comorbidities. | en_US |
