Loading
Infections and Bacterial Resistance / Burkholderia Infections and Melioidosis / Infectious Disease Case Reports and Treatments · Journal article
American Journal of Tropical Medicine and Hygiene · August 11, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report describing an unusual presentation of chronic melioidosis with concurrent pulmonary infection, empyema, and splenic abscess in a patient with diabetes mellitus. The case documents successful identification via pleural effusion culture of Burkholderia pseudomallei and clinical response to a defined antimicrobial regimen (intravenous ceftazidime followed by oral trimethoprim/sulfamethoxazole), but provides no comparative outcome data and does not establish epidemiologic patterns or treatment efficacy benchmarks.
Case report. Single patient with chronic melioidosis, diabetes mellitus, and recurrent chest pain, cough, and abdominal discomfort from an endemic area. Intervention: Thoracic puncture and catheter drainage; intravenous ceftazidime intensive phase followed by oral trimethoprim/sulfamethoxazole eradication phase. Not specified in abstract.
Patient presented with recurrent chest pain, cough, and abdominal discomfort for 11 months, initially misdiagnosed as common bacterial infection Pleural effusion culture identified Burkholderia pseudomallei Imaging revealed pulmonary infection, left pleural effusion, and multiple low-density lesions in and around the spleen
No quantitative outcome measures, mortality rate, or follow-up duration reported
This case highlights the need for clinicians in endemic regions to maintain heightened suspicion for melioidosis in patients with pneumonia accompanied by parapneumonic pleural effusion and splenic abscesses, particularly those with diabetes. Early recognition and culture-based diagnosis, combined with appropriate antimicrobial therapy (ceftazidime induction followed by trimethoprim/sulfamethoxazole eradication), may prevent progression to severe sepsis.
Single case report of an uncommon clinical presentation; documents diagnosis and management but lacks comparative data, control group, or outcome statistics needed for stronger evidence grades.
As stated by the source record.
Quoted from the source exactly as published.
This case highlights the need for clinicians in endemic regions to maintain heightened suspicion for melioidosis in patients with pneumonia accompanied by parapneumonic pleural effusion and splenic abscesses, particularly those with diabetes. Early recognition and culture-based diagnosis, combined with appropriate antimicrobial therapy (ceftazidime induction followed by trimethoprim/sulfamethoxazole eradication), may prevent progression to severe sepsis.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
ABSTRACT. Melioidosis is an emerging tropical infectious disease with diverse clinical manifestations and a high fatality rate. We report a rare case of chronic melioidosis manifesting as pulmonary infection, empyema, and splenic abscess. The patient presented with recurrent chest pain, cough, and abdominal discomfort for 11 months, initially misdiagnosed as common bacterial infection. Computed tomography imaging revealed pulmonary infection, left pleural effusion, and multiple abnormal low-density lesions in and around the spleen. Pleural effusion culture identified Burkholderia pseudomallei. Management included thoracic puncture and catheter drainage, an intensive phase of intravenous ceftazidime, followed by an eradication phase with oral trimethoprim/sulfamethoxazole. The patient showed clinical and radiological improvements. Clinicians should consider chronic melioidosis in patients with pneumonia and parapneumonic pleural effusion accompanied by splenic abscesses, particularly in patients with diabetes mellitus from endemic areas. Early recognition, definitive diagnosis, and tailored antimicrobial therapy are essential to prevent the progression of severe pneumonia and sepsis.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.