Splenic abscess in a diabetic patient, Melioidosis: A case study

Abstract

Burkholderia pseudomallei is the causative organism for Melioidosis. This is a ubiquitous organism which produces symptoms ranging from no symptoms to abscess in internal organs like liver and spleen finally leading to septic shock. 45 years old female patient doing agriculture having diabetes and hypertension presented with high grade fever and acute lower abdominal pain. CT abdomen showed multiple well defined lesions involving spleen. USG guided pigtail aspiration of the purulent aspirate in direct Gram stain revealed many pus cells, Gram negative bacilli seen (safety pin appearance). Cultured on standard bacteriological media, identified as Burkholderia pseudomallei with conventional techniques. Chronic case of diabetes and hypertensive with irregular treatment could add on to immunosuppressive state leading to infection and was treated with Meropenem and Cotrimoxazole following which patient clinically improved. Thus a holistic approach with clinicians and microbiologists plays a crucial role in the treatment of Melioidosis”