Melioidosis presenting as parotid abscess in children: two consecutive cases

Melioidosis is an emerging infection in Sri Lanka with increasing case reports, mostly in adults but also in children. We report two children with parotid abscess, which is one of the common clinical manifestations in the paediatric population in Southeast Asia but rare in Northern Australia. Both were previously healthy. The children recovered completely after surgical drainage and antibiotic treatment according to standard guidelines. Because the spectrum of disease in childhood is different from that in adults and underlying predisposing factors are usually not seen in children, a high index of suspicion is required for the diagnosis of paediatric melioidosis. Raising awareness among paediatricians in Sri Lanka of the clinical presentations of melioidosis in childhood is a prerequisite for improved ascertainment. The key role of the microbiology laboratory in the diagnosis of melioidosis is highlighted.