Abstract

BACKGROUND: In regions endemic for tuberculosis (TB) such as India, presumptive anti-tuberculosis treatment is often prescribed. Melioidosis, caused by Burk-holderia pseudotnallei, is underdiagnosed in India, due to lack of awareness and a low index of suspicion. SETTING: A tertiary care hospital in south India. OBJECTIVE: To present our analysis of a series of 22 cases of suspected TB that was later confirmed as melioidosis. DESIGN: Twenty-two patients with culture-proven melioidosis, who were initially given empirical anti-tuberculosis treatment, were retrospectively analysed regarding clinical presentation, laboratory findings and epidemiological features, with a view to determining any significant discriminatory parameter/s that would help distinguish the two diseases. RESULTS: Eight cases mimicked pulmonary TB, five tubercular arthritis, three tubercular spondylitis, two tubercular lymphadenitis, two splenic abscess, and one each mimicked tubercular pericarditis and parotid abscess. Fever was the chief presenting complaint; all had high erythrocyte sedimentation rate (ESR) values (mean 111 mm ± 23.7 SD); 15 (68.2%) had neutrophilic leuco-cytosis, 20 (90.9%) had diabetes mellitus. Subsequent to laboratory culture reports confirming melioidosis, appropriate treatment was instituted. CONCLUSION: Fever in a diabetic patient with high ESR and neutrophilic leucocytosis should raise suspicion of melioidosis while instituting presumptive anti-tuberculosis treatment in areas where both diseases are prevalent.

Original languageEnglish
Pages (from-to)1209-1215
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume12
Issue number10
Publication statusPublished - 01-10-2008

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Melioidosis
Tuberculosis
India
Blood Sedimentation
Abscess
Fever
Spondylitis
Lymphadenitis
Pericarditis
Leukocytosis
Tertiary Healthcare
Therapeutics
Pulmonary Tuberculosis
Tertiary Care Centers
Arthritis
Diabetes Mellitus

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

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title = "Tuberculosis mimicked by Melioidosis",
abstract = "BACKGROUND: In regions endemic for tuberculosis (TB) such as India, presumptive anti-tuberculosis treatment is often prescribed. Melioidosis, caused by Burk-holderia pseudotnallei, is underdiagnosed in India, due to lack of awareness and a low index of suspicion. SETTING: A tertiary care hospital in south India. OBJECTIVE: To present our analysis of a series of 22 cases of suspected TB that was later confirmed as melioidosis. DESIGN: Twenty-two patients with culture-proven melioidosis, who were initially given empirical anti-tuberculosis treatment, were retrospectively analysed regarding clinical presentation, laboratory findings and epidemiological features, with a view to determining any significant discriminatory parameter/s that would help distinguish the two diseases. RESULTS: Eight cases mimicked pulmonary TB, five tubercular arthritis, three tubercular spondylitis, two tubercular lymphadenitis, two splenic abscess, and one each mimicked tubercular pericarditis and parotid abscess. Fever was the chief presenting complaint; all had high erythrocyte sedimentation rate (ESR) values (mean 111 mm ± 23.7 SD); 15 (68.2{\%}) had neutrophilic leuco-cytosis, 20 (90.9{\%}) had diabetes mellitus. Subsequent to laboratory culture reports confirming melioidosis, appropriate treatment was instituted. CONCLUSION: Fever in a diabetic patient with high ESR and neutrophilic leucocytosis should raise suspicion of melioidosis while instituting presumptive anti-tuberculosis treatment in areas where both diseases are prevalent.",
author = "K. Vidyalakshmi and M. Chakrapani and B. Shrikala and S. Damodar and S. Lipika and S. Vishal",
year = "2008",
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Tuberculosis mimicked by Melioidosis. / Vidyalakshmi, K.; Chakrapani, M.; Shrikala, B.; Damodar, S.; Lipika, S.; Vishal, S.

In: International Journal of Tuberculosis and Lung Disease, Vol. 12, No. 10, 01.10.2008, p. 1209-1215.

Research output: Contribution to journalArticle

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T1 - Tuberculosis mimicked by Melioidosis

AU - Vidyalakshmi, K.

AU - Chakrapani, M.

AU - Shrikala, B.

AU - Damodar, S.

AU - Lipika, S.

AU - Vishal, S.

PY - 2008/10/1

Y1 - 2008/10/1

N2 - BACKGROUND: In regions endemic for tuberculosis (TB) such as India, presumptive anti-tuberculosis treatment is often prescribed. Melioidosis, caused by Burk-holderia pseudotnallei, is underdiagnosed in India, due to lack of awareness and a low index of suspicion. SETTING: A tertiary care hospital in south India. OBJECTIVE: To present our analysis of a series of 22 cases of suspected TB that was later confirmed as melioidosis. DESIGN: Twenty-two patients with culture-proven melioidosis, who were initially given empirical anti-tuberculosis treatment, were retrospectively analysed regarding clinical presentation, laboratory findings and epidemiological features, with a view to determining any significant discriminatory parameter/s that would help distinguish the two diseases. RESULTS: Eight cases mimicked pulmonary TB, five tubercular arthritis, three tubercular spondylitis, two tubercular lymphadenitis, two splenic abscess, and one each mimicked tubercular pericarditis and parotid abscess. Fever was the chief presenting complaint; all had high erythrocyte sedimentation rate (ESR) values (mean 111 mm ± 23.7 SD); 15 (68.2%) had neutrophilic leuco-cytosis, 20 (90.9%) had diabetes mellitus. Subsequent to laboratory culture reports confirming melioidosis, appropriate treatment was instituted. CONCLUSION: Fever in a diabetic patient with high ESR and neutrophilic leucocytosis should raise suspicion of melioidosis while instituting presumptive anti-tuberculosis treatment in areas where both diseases are prevalent.

AB - BACKGROUND: In regions endemic for tuberculosis (TB) such as India, presumptive anti-tuberculosis treatment is often prescribed. Melioidosis, caused by Burk-holderia pseudotnallei, is underdiagnosed in India, due to lack of awareness and a low index of suspicion. SETTING: A tertiary care hospital in south India. OBJECTIVE: To present our analysis of a series of 22 cases of suspected TB that was later confirmed as melioidosis. DESIGN: Twenty-two patients with culture-proven melioidosis, who were initially given empirical anti-tuberculosis treatment, were retrospectively analysed regarding clinical presentation, laboratory findings and epidemiological features, with a view to determining any significant discriminatory parameter/s that would help distinguish the two diseases. RESULTS: Eight cases mimicked pulmonary TB, five tubercular arthritis, three tubercular spondylitis, two tubercular lymphadenitis, two splenic abscess, and one each mimicked tubercular pericarditis and parotid abscess. Fever was the chief presenting complaint; all had high erythrocyte sedimentation rate (ESR) values (mean 111 mm ± 23.7 SD); 15 (68.2%) had neutrophilic leuco-cytosis, 20 (90.9%) had diabetes mellitus. Subsequent to laboratory culture reports confirming melioidosis, appropriate treatment was instituted. CONCLUSION: Fever in a diabetic patient with high ESR and neutrophilic leucocytosis should raise suspicion of melioidosis while instituting presumptive anti-tuberculosis treatment in areas where both diseases are prevalent.

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