Melioidosis in acute cholangitis of diabetic patient: a forgotten diagnosis

• Published in: Research and reports in tropical medicine Vol. 3; no. default; pp. 103 - 106
• Main Authors: Mohamad, Nasir, Ponnusamy, Suresh, Devi, Sunita, Manikam, Rishya, Idrus, Ilya Irinaz, Bakar, Nor Hidayah Abu
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2012; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Bacterial pneumonia; Blood; Care and treatment; Case Report; Diabetes; Diabetics; Diagnosis; Health aspects; Medical examination; Pneumonia; Primary care; Pseudomonas infections; Toy industry; Malaysia; high suspicion; primary care; Burkholderia pseudomallei; atypical
• ISSN: 1179-7282; 1179-7282
• DOI: 10.2147/RRTM.S34483

Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infection. Hence, its diagnosis depends heavily on the clinical microbiology laboratory for culture. In this case report, we describe an atypical presentation of melioidosis in a 52-year-old man who had fever, right upper-abdominal pain, and jaundice for 15 days. Melioidosis caused by was subsequently diagnosed from blood culture. As a primary care physician, high suspicion index is of great importance. High suspicion index of melioidosis in a high-risk group patient, such as the patient with diabetes mellitus and diabetic foot, is crucial in view of atypical presentations of pseudomonas sepsis. A correct combination of antibiotic administration in the early phase of therapy will determine its successful outcome.