Authors
Belwal Veerappa Shankaraa, Parameswaran Baburaja, Sneha Susan Jacoba. aDepartment of Medicine, Jubilee Mission Medical College & Research Institute, East Fort, Thrissur, Kerala
Abstract
Melioidosis is caused by a gram-negative bacterium Burkholderia pseudomallei is geographically restricted to South East Asia & Northern Australia. In India many cases have been reported in recent years. This study was undertaken to analyze the varied clinical presentation and increased incidence of melioidosis. We carried out a retrospective study of eight cultures proven cases of melioidosis at a tertiary care hospital in Kerala, South India between July 2014 and Feb 2016.
Melioidosis infection in human beings may present as two forms, acute or chronic. The clinical presentation of melioidosis is highly variable and may mimic those of tuberculosis. Microbiological culture remains the standard method for the diagnosis of melioidosis. Treatment is usually divided into two phases, intensive phase for 10-14 days and eradication phase for a minimum of 12- 24 weeks. Currently there is no licensed vaccine available for melioidosis.
The commonest risk factor in our study was diabetes and alcoholism was the second commonest risk factor for melioidosis. But host immunity compromise may not a prerequisite for Melioidosis, as it can occur in any healthy children or adults. The disease has been shown to mimic tuberculosis. Abscess was the most common clinical presentation (87.5%) in contrast to earlier studies which showed fever as most common presentation.
The incidence of melioidosis cases are increasing in India, as in rest of the world. Increase in diabetic patients in Indian popula- tion is one of the important risk factor for increased incidence and also increased awareness among clinicians and microbiologists resulting in better recognition and reporting.