Melioidosis mimicking tubercular cold abscess

BMJ Case Rep. 2017 Sep 19:2017:bcr2017221787. doi: 10.1136/bcr-2017-221787.

Abstract

Burkholderia pseudomallei is a Gram-negative bacillus found in soil. The infection is thought to occur by inoculation or inhalation. It usually affects people with predisposing factors like diabetes mellitus and chronic alcoholism. A 36-year-old man, on the treatment of diabetes in the past 4 years, on oral hypoglycaemic drugs, presented to us with pain and insidious onset of swelling over left loin like a lumbar cold abscess. He underwent incision and drainage of the abscess. As per the culture report, we used ceftazidime for 2 weeks, followed by cotrimoxazole for 6 months. Surgical drainage of large abscesses is indicated. A dedicated team of microbiologist and physicians is required to identify and treat the disease. Orthopaedic manifestations are uncommon.

Keywords: bone and joint infections; infectious diseases.

Publication types

  • Case Reports

MeSH terms

  • Abscess / complications
  • Abscess / diagnosis*
  • Abscess / diagnostic imaging
  • Abscess / surgery
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Burkholderia pseudomallei / isolation & purification*
  • Ceftazidime / administration & dosage
  • Ceftazidime / therapeutic use
  • Diabetes Mellitus, Type 2*
  • Diagnosis, Differential
  • Humans
  • Lumbosacral Region*
  • Magnetic Resonance Imaging
  • Male
  • Melioidosis / complications
  • Melioidosis / diagnosis*
  • Melioidosis / diagnostic imaging
  • Melioidosis / drug therapy
  • Tuberculosis / complications
  • Tuberculosis / diagnosis*
  • Tuberculosis / diagnostic imaging
  • Tuberculosis / drug therapy

Substances

  • Anti-Bacterial Agents
  • Ceftazidime