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Melioidosis and tuberculosis: dual pathogens in a neck abscess

Published online by Cambridge University Press:  21 January 2009

V Shenoy ,
M P Kamath ,
M C Hegde ,
T D'Souza  and
S S Mammen
V Shenoy*
Affiliation:
Department of ENT and Head and Neck Surgery, Kasturba Medical College, Mangalore, India
M P Kamath
Affiliation:
Department of ENT and Head and Neck Surgery, Kasturba Medical College, Mangalore, India
M C Hegde
Affiliation:
Department of ENT and Head and Neck Surgery, Kasturba Medical College, Mangalore, India
T D'Souza
Affiliation:
Department of ENT and Head and Neck Surgery, Kasturba Medical College, Mangalore, India
S S Mammen
Affiliation:
Department of ENT and Head and Neck Surgery, Kasturba Medical College, Mangalore, India
*
Address for correspondence: Dr Vijendra Shenoy, Department of ENT and head & neck surgery, Kasturba Medical College Hospital, Attavar, Mangalore 575 001, Karnataka State, India. Fax: 0091 824 2428379 E-mail: drvijendras@gmail.com
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Abstract

Introduction:

Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, abscesses in soft tissue and various organs, or as septicaemia.

Case report:

We report a case of a 40-year-old, diabetic man who presented with a neck lump resulting from super-infection of a tuberculosis cavity with B pseudomallei. The patient was successfully managed by drainage along with meticulous excision of the capsule and prolonged antibiotic and anti-tubercular treatment.

Discussion:

Melioidosis may be confused diagnostically with tuberculosis, as both diseases are endemic in the same regions. Our patient was unfortunate to suffer from both endemic diseases simultaneously, perhaps representing the first such case in the world literature.

Conclusion:

Increased awareness of melioidosis is important as, although the organism is easy to culture, it may be dismissed as a contaminant.

Keywords

Burkholderia PseudomalleiNeckAbscessTuberculosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 11 , November 2009 , pp. 1285 - 1287
Copyright
Copyright © JLO (1984) Limited 2009

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