Imaging case series of melioidosis: the great masquerader

Abstract

BackgroundMelioidosis is an infectious disease caused by Gram-negative bacterium Burkholderia pseudomallei. It is endemic to Southeast Asia. Inhalation, inoculation and ingestion are major routes of transmission. Increased risk of infection is seen in patients with diabetes, alcoholism, chronic renal and liver failure and malignancy. The aim of the present case series is to describe the varied imaging manifestations of melioidosis.Case presentationThis is a retrospective review of imaging findings in eight patients with culture-proven B. pseudomallei infections diagnosed in our institute from September 2019 to September 2021. A total of eight culture-proven melioidosis cases were reported from our institute. All of them had multiorgan involvement and predisposing conditions or risk factors, most common being diabetes mellitus and alcoholism. Lung was the most common organ involved showing nodules and consolidations followed by liver and spleen demonstrating multiple ‘honeycomb’-like abscesses. Musculoskeletal manifestations included osteomyelitis and intramuscular abscess. Cerebral abscess, cerebral infarcts, prostatic abscess, abdominal aortic mycotic aneurysm with periaortic hematoma and splenic vein thrombosis with splenic infarcts were a few other manifestations.ConclusionsMelioidosis is a great mimicker with acute, subacute or chronic clinical course involving multiple organs and resembling other common infections. Hence, it should be considered as a possible etiological agent when evaluating patients with risk factors and multiorgan involvement.