Disseminated Melioidosis Presenting with Community-Acquired Pneumonia: A Presentation Not to be Missed – A Case Report

Shaun Wayn Paul; Khasnur Abd Malek; Alan Basil Peter; Sabrilhakim Sidek

doi:10.3889/oamjms.2020.4199

Authors

Shaun Wayn Paul Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100 Batu Caves, Selangor, Malaysia
Khasnur Abd Malek Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Jalan Prima Selayang 7, 68100 Batu Caves, Selangor, Malaysia
Alan Basil Peter Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
Sabrilhakim Sidek Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia

DOI:

https://doi.org/10.3889/oamjms.2020.4199

Keywords:

disseminated melioidosis, pneumonia, abscesses, sepsis

Abstract

BACKGROUND: Melioidosis commonly presents with pneumonia and is associated with a high mortality rate. This case report discussed a case of confirmed disseminated melioidosis. The case focused on the chronological clinical progressions of melioidosis which initially masqueraded as community-acquired pneumonia (CAP) and subsequently developed into septicemia. This case report aims to create awareness among the primary care doctors working in a potentially endemic area for melioidosis to be vigilant of its non-specific presentation.

CASE REPORT: We report a case of an 80-year-old man who was treated for CAP and presented with unresolved fever and subsequently sepsis. A contrast-enhanced computed tomography showed disseminated lesions of varying sizes in the lungs, liver, spleen, and blood cultures grew Burkholderia pseudomallei. A pigtail drainage catheter was inserted into the liver abscess. In addition, the patient received a 46-day course of intravenous ceftazidime and a 4-month maintenance regime of oral trimethoprim-sulfamethoxazole and oral doxycycline.

CONCLUSION: Completion of antimicrobial treatment resulted in resolution of clinical signs and abscesses on imaging.

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