Aquatic to pulmonary: Severe melioidosis following near-drowning from Southern India

Melioidosis is a known emerging infectious disease in India. Pulmonary melioidosis presents as acute fulminant septecemia, subacute illness, chronic infection, or subclinical disease. Aspiration of water containing bacteria is an unique mode of transmission, which can give rise to pulmonary melioidosis with or without septicaemia. The two unique presentations of pulmonary melioidosis in non-diabetic patients were documented following fresh water drowning and aspiration of water. They had different clinical and radiological presentation, course of illness, and outcome, although the source of infection was similar. One of the patient succumbed to septecemic shock while the other survived with the adequate treatment. Melioidosis was never the differential diagnosis in both the cases. It shows the urgency of the disease to be highlighted in this part of the world, especially among the clinicians and microbiologists, so every similar episode of drowning might be complimented by the work up of melioidosis and managed as critical.