Melioidosis

A rare case of hemoptysis with pseudoaneurysm

B. Jayaprakash, N. Karthik Rao, Navin Patil, O. Balaji, N. R. Rau, George Varghese

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Melioidosis, a highly contagious disease, often fatal caused by Burkholderia pseudomallei, a gram negative bacteria, often lurks in water, soil and air and is widely prevalent in India. It is a nightmare to the physician to reach to a substantial diagnosis as it mimics various infections. High variability is seen in the clinical presentation and ranges from acute respiratory illness to chronic debilitating illness with pneumonia being the commonest presentation. Sputum culture remains the gold standard for diagnosing melioidosis. Antibiotics remains the choice of treatment. It often presents as community-acquired pneumonia and sepsis, but can involve almost any part of the body. In this case report, we illustrate a rare but fatal complication of this increasingly reported and important disease. A 61 year old patient, known alcoholic, smoker and a diabetic, presents with low grade fever, night sweats associated with cough and hemoptysis since 10 days to the emergency department. Vitals were stable and chest X-ray revealed right hilar prominence with opacity in upper zone and CT scan reveals right apical segment cavity with pseudoaneurysm and centrilobular nodules. Sputum samples for AFB and malignant cells were negative. Sputum culture showed burkholderia pseudomallei sensitive to ceftazidime and the patient was started on parenteral ceftazidime, continued for 10 days and then shifted to oral ceftazidime and cotrimoxazole for a period of 8 weeks. The condition of the patient gradually improved, hemoptysis stopped in two weeks. After 8 weeks on follow up visit patient was clinically normal. Further studies are necessary to determine the medical, economical impact and their outcomes in endemic population in India.

Original languageEnglish
Pages (from-to)1977-1981
Number of pages5
JournalResearch Journal of Pharmaceutical, Biological and Chemical Sciences
Volume7
Issue number3
Publication statusPublished - 01-01-2016

Fingerprint

Melioidosis
Ceftazidime
Hemoptysis
False Aneurysm
Sputum
Burkholderia pseudomallei
India
Pneumonia
Computerized tomography
Sulfamethoxazole Drug Combination Trimethoprim
Opacity
Sweat
Bacteria
Gram-Negative Bacteria
Human Body
Cough
Anti-Bacterial Agents
Soils
Hospital Emergency Service
X rays

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Jayaprakash, B., Karthik Rao, N., Patil, N., Balaji, O., Rau, N. R., & Varghese, G. (2016). Melioidosis: A rare case of hemoptysis with pseudoaneurysm. Research Journal of Pharmaceutical, Biological and Chemical Sciences, 7(3), 1977-1981.
Jayaprakash, B. ; Karthik Rao, N. ; Patil, Navin ; Balaji, O. ; Rau, N. R. ; Varghese, George. / Melioidosis : A rare case of hemoptysis with pseudoaneurysm. In: Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2016 ; Vol. 7, No. 3. pp. 1977-1981.
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Jayaprakash, B, Karthik Rao, N, Patil, N, Balaji, O, Rau, NR & Varghese, G 2016, 'Melioidosis: A rare case of hemoptysis with pseudoaneurysm', Research Journal of Pharmaceutical, Biological and Chemical Sciences, vol. 7, no. 3, pp. 1977-1981.

Melioidosis : A rare case of hemoptysis with pseudoaneurysm. / Jayaprakash, B.; Karthik Rao, N.; Patil, Navin; Balaji, O.; Rau, N. R.; Varghese, George.

In: Research Journal of Pharmaceutical, Biological and Chemical Sciences, Vol. 7, No. 3, 01.01.2016, p. 1977-1981.

Research output: Contribution to journalArticle

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T2 - A rare case of hemoptysis with pseudoaneurysm

AU - Jayaprakash, B.

AU - Karthik Rao, N.

AU - Patil, Navin

AU - Balaji, O.

AU - Rau, N. R.

AU - Varghese, George

PY - 2016/1/1

Y1 - 2016/1/1

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AB - Melioidosis, a highly contagious disease, often fatal caused by Burkholderia pseudomallei, a gram negative bacteria, often lurks in water, soil and air and is widely prevalent in India. It is a nightmare to the physician to reach to a substantial diagnosis as it mimics various infections. High variability is seen in the clinical presentation and ranges from acute respiratory illness to chronic debilitating illness with pneumonia being the commonest presentation. Sputum culture remains the gold standard for diagnosing melioidosis. Antibiotics remains the choice of treatment. It often presents as community-acquired pneumonia and sepsis, but can involve almost any part of the body. In this case report, we illustrate a rare but fatal complication of this increasingly reported and important disease. A 61 year old patient, known alcoholic, smoker and a diabetic, presents with low grade fever, night sweats associated with cough and hemoptysis since 10 days to the emergency department. Vitals were stable and chest X-ray revealed right hilar prominence with opacity in upper zone and CT scan reveals right apical segment cavity with pseudoaneurysm and centrilobular nodules. Sputum samples for AFB and malignant cells were negative. Sputum culture showed burkholderia pseudomallei sensitive to ceftazidime and the patient was started on parenteral ceftazidime, continued for 10 days and then shifted to oral ceftazidime and cotrimoxazole for a period of 8 weeks. The condition of the patient gradually improved, hemoptysis stopped in two weeks. After 8 weeks on follow up visit patient was clinically normal. Further studies are necessary to determine the medical, economical impact and their outcomes in endemic population in India.

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Jayaprakash B, Karthik Rao N, Patil N, Balaji O, Rau NR, Varghese G. Melioidosis: A rare case of hemoptysis with pseudoaneurysm. Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2016 Jan 1;7(3):1977-1981.