A review of imaging findings in melioidosis: revealing the tropics’ dirty secret

Abstract

ObjectiveMelioidosis is a neglected tropical disease caused by the Burkholderia pseudomallei bacterium. Currently, serologically-proven cases are likely to represent only the ‘tip of the iceberg’ as culture facilities are not widely available within endemic areas. With globally increasing population and temperatures, it is hypothesised that areas which B. pseudomallei is endemic to will expand. Melioidosis confers significant mortality and morbidity and is associated with a diverse range of imaging findings. This pictorial essay aims to describe the common and life-threatening imaging features of melioidosis. MethodsA retrospective review was undertaken on imaging performed in culture-confirmed cases of melioidosis at a single institution over a 5-year period. ResultsTypical and atypical imaging findings demonstrating involvement of multiple organs are presented. ConclusionEffective treatment for melioidosis requires early diagnosis and a multi-disciplinary approach with involvement of physicians, surgeons, and interventional radiologists. Where available, early CT imaging should be performed to investigate potential bacterial seeding. Radiologists working in endemic areas or examining returned overseas travellers should be familiar with the imaging findings to aid diagnosis and management in these patients.