Clinical Spectrum of Melioidosis in Diabetic Patients: A Case Series from a Tertiary Care Center in India
Vani Majji *
KIMS Hospital Enterprises Pvt. Ltd., Kondapur and PRK Hospitals, Chandanagar, India.
K. Sreedhar
KIMS Hospital Enterprises Pvt. Ltd., India.
Ajay Patwadi
Department of Minimal Access, Bariatric and Gastrosurgery, PRK Hospitals, Chandanagar, Hyderabad, India.
Talluri Bhavishya
KIMS Hospital Enterprises Pvt. Ltd., India.
*Author to whom correspondence should be addressed.
Abstract
Background: Melioidosis, caused by Burkholderia pseudomallei, is an emerging infectious disease in Southeast Asia and the Indian subcontinent. Diabetes mellitus is the most significant predisposing factor. The disease presents a diagnostic challenge due to its wide clinical spectrum and mimicry of other common infections.
Case Summary: We describe three cases of culture-confirmed Melioidosis in male patients with diabetes mellitus, each presenting with different manifestations — chronic soft tissue abscess, disseminated visceral abscesses with vascular complications, and rapidly progressive cellulitis. All cases required surgical or radiological intervention, prolonged intravenous antibiotic therapy, and a structured eradication phase with oral antibiotics. Each patient responded favourably to treatment with no early recurrence.
Conclusion: This case series underscores the protean nature of Melioidosis in diabetic patients. A high index of suspicion, timely diagnosis through microbiological culture, and adherence to the two-phase treatment protocol are critical for favourable outcomes.
Keywords: Melioidosis, burkholderia pseudomallei, diabetes mellitus, abscess, tropical infections