Cavitating left upper lobe pneumonia; a case of Melioidosis

Melioidosis is a bacterial infection caused by Burkholderia pseudomallei. The first cases of melioidosis were described in Burma just over a century ago. Since then, the endemic zone has expanded and includes Sri Lanka. The clinical presentation of melioidosis ranges from acute, subacute and chronic manifestations. Due to its protean clinical presentation, a high index of suspicion is necessary for the clinical diagnosis. Diagnosis is confirmed by isolation of B. pseudomallei from clinical specimens. A high or rising antibody titre to melioidin antigen is supportive, but not diagnostic. B. pseudomallei grows readily in commonly used laboratory media but may not be identified unless laboratory personnel have prior experience with this organism. Treatment is complex and includes a prolonged course of intravenous antibiotics followed by months of oral therapy to ensure eradication of the bacterium. Relapse is common in spite of adequate therapy. Acase report of a patient with acute onset pneumonia with a positive sputum culture of B.pseudomallei is presented.

DOI: http://dx.doi.org/10.4038/gmj.v19i1.6955

Galle Medical Journal 2014 19(1): 23-26