Indian Journal of Critical Care Case Report

Register      Login

VOLUME 4 , ISSUE 1 ( January-February, 2025 ) > List of Articles

CASE REPORT

A Case of Hepatic, Splenic, and Prostatic Abscesses in One Patient with Burkholderia pseudomallei Infection

Cherian Roy, Rupali Patnaik, Shakti B Mishra, Pragnya P Jena

Keywords : Burkholderia pseudomallei, Case report, Multifocal abscess, Septic shock

Citation Information : Roy C, Patnaik R, Mishra SB, Jena PP. A Case of Hepatic, Splenic, and Prostatic Abscesses in One Patient with Burkholderia pseudomallei Infection. 2025; 4 (1):15-18.

DOI: 10.5005/jp-journals-11006-0145

License: CC BY-NC 4.0

Published Online: 30-12-2024

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Introduction: Melioidosis results from infection by Burkholderia pseudomallei. Clinical presentation ranges from asymptomatic infection to fulminant septicemia with septic shock. We describe a case where one patient with pneumonia and septic shock was found to have a disseminated abscesses there in the liver, spleen, and prostate. Case description: He was presented to the hospital emergency with septic shock and hypoxemic respiratory failure and transferred to the intensive care unit (ICU). Two sets of blood cultures sent at admission showed growth of nonlactose fermenting gram-negative rods. The organism was identified as B. pseudomallei by an automated VITEK2 Compact system. Computed tomography (CT) scan of the abdomen and pelvis revealed hepatomegaly with multiple abscesses, multiple splenic micro abscesses, prostatomegaly with multiple prostatic abscesses, and of thorax suggested multiple variable-sized nodules with subpleural consolidation. He received intravenous meropenem followed by ceftazidime for a total of 4 weeks. With clinical resolution, he was started on oral antibiotics trimethoprim-sulfamethoxazole and was discharged home to continue for 3 months. Discussion: Disseminated abscesses especially involving the liver and spleen are characteristics of melioidosis. Interestingly, in our case, a single patient had multifocal abscesses involving the liver, spleen, and prostate along with lung involvement. Conclusion: Melioidosis with disseminated abscess in a single patient especially of prostatic abscess as in our case has been rarely reported.


PDF Share
  1. Limmathurotsakul D, Golding N, Dance DA, et al. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 2016;1(1):15008. DOI: 10.1038/nmicrobiol.2015.8
  2. Wiersinga WJ, Virk HS, Torres AG, et al. Melioidosis. Nat Rev Dis Primers 2018;4:17107. DOI: 10.1038/nrdp.2017.107
  3. Whitmore A. An account of a glanders-like disease occurring in Rangoon. J Hyg (Lond) 1913;13(1):1–34. DOI: 10.1017/s0022172400005234
  4. Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 2005;18(2):383–416. DOI: 10.1128/CMR.18.2.383-416.2005
  5. Singh M, Mahmood M. Melioidosis: the great mimicker. J Community Hosp Intern Med Perspect 2017;7(4):245–247. DOI: 10.1080/20009666.2017.1348875
  6. Currie BJ, Fisher DA, Howard DM, et al. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 2000;31(4):981–986. DOI: 10.1086/318116
  7. Apisarnthanarak A, Apisarnthanarak P, Mundy LM. Computed tomography characteristics of Burkholderia pseudomallei liver abscess. Clin Infect Dis 2006;42(7):989–993. DOI: 10.1086/501017
  8. Alsaif HS, Venkatesh SK. Melioidosis: spectrum of radiological manifestations. Saudi J Med Sci 2016;4:74–78. DOI: 10.4103/1658-631X.178286
  9. Khiangte HL, Robinson Vimala L, Veeraraghavan B, et al. Can the imaging manifestations of melioidosis prognosticate the clinical outcome? A 6-year retrospective study. Insights Imaging 2019;10(1):17. DOI: 10.1186/s13244-019-0708-8
  10. Peddayelachagiri BV, Paul S, Nagaraj S, et al. Prevalence and identification of Burkholderia pseudomallei and near-neighbor species in the Malabar coastal region of India. PLoS Negl Trop Dis 2016;10(9):e0004956. DOI: 10.1371/journal.pntd.0004956
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.