Melioidosis

The great mimicker presenting as spondylodiscitis

Research output: Contribution to journalArticle

Abstract

Melioidosis, a syndrome with protean clinical manifestations, is caused by Gram-negative soil saprophyte Burkholderiapseudomallei. Among its diverse clinical presentations, the involvement of spine is a rare phenomenon and can mimic tuberculosis on presentation. A 65-year-old female with a known case of diabetes presented with fever with lower back pain. Blood culture grew Staphylococcus aureus, and as per sensitivity report, clindamycin and cefazolin were started. X-ray and MRI lumbosacral spine showed spondylodiscitis (likely Koch's). Decompression and biopsy were done, and a sample was sent for microbiological investigations that showed no growth of any significant pathogen; furthermore, all tests for tuberculosis diagnosis also remained negative. Active Melioidosis Detect Lateral Flow Assay was used on the tissue sample, which was positive for B. pseudomallei Capsular Polysaccharide (CPS) antigen; the case was confirmed by typethree secretion system 1 PCR for melioidosis. Antibiotics were changed to parenteral ceftazidime for 2 weeks followed by oral cotrimoxazole. A dedicated team of microbiologists and physicians is required to identify and treat the disease.

Original languageEnglish
Article numberA220
JournalBMJ Case Reports
Volume2018
DOIs
Publication statusPublished - 01-01-2018

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Melioidosis
Discitis
Tuberculosis
Spine
Cefazolin
Ceftazidime
Clindamycin
Sulfamethoxazole Drug Combination Trimethoprim
Low Back Pain
Decompression
Polysaccharides
Staphylococcus aureus
Fever
Soil
X-Rays
Anti-Bacterial Agents
Physicians
Biopsy
Antigens
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Melioidosis: The great mimicker presenting as spondylodiscitis",
abstract = "Melioidosis, a syndrome with protean clinical manifestations, is caused by Gram-negative soil saprophyte Burkholderiapseudomallei. Among its diverse clinical presentations, the involvement of spine is a rare phenomenon and can mimic tuberculosis on presentation. A 65-year-old female with a known case of diabetes presented with fever with lower back pain. Blood culture grew Staphylococcus aureus, and as per sensitivity report, clindamycin and cefazolin were started. X-ray and MRI lumbosacral spine showed spondylodiscitis (likely Koch's). Decompression and biopsy were done, and a sample was sent for microbiological investigations that showed no growth of any significant pathogen; furthermore, all tests for tuberculosis diagnosis also remained negative. Active Melioidosis Detect Lateral Flow Assay was used on the tissue sample, which was positive for B. pseudomallei Capsular Polysaccharide (CPS) antigen; the case was confirmed by typethree secretion system 1 PCR for melioidosis. Antibiotics were changed to parenteral ceftazidime for 2 weeks followed by oral cotrimoxazole. A dedicated team of microbiologists and physicians is required to identify and treat the disease.",
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Melioidosis : The great mimicker presenting as spondylodiscitis. / Garg, Rahul; Shaw, Tushar; Bhat, Shyamasunder N.; Mukhopadhyay, Chiranjay.

In: BMJ Case Reports, Vol. 2018, A220, 01.01.2018.

Research output: Contribution to journalArticle

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