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Melioidosis: an unusual diagnosis for deep temporal and masticatory space infection following trauma
  1. Nikhil Sadashiv Shetty1,
  2. Arvind Karikal2 and
  3. Sharanya Menon Radhakrishnan2
  1. 1Plastic Surgery, KS Hegde Medical Academy, Mangalore, Karnataka, India
  2. 2Oral & Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
  1. Correspondence to Dr Arvind Karikal; draravindkarikal{at}


We report a patient in his early 70s, with an alleged history of trauma to the right temporal region, following which a swelling developed. A week later, erythematous changes, throbbing pain and occasional fever spikes were noted. A month after the initial trauma, he presented to our institution with necrosed skin over the right temporal region and swelling extending up to the vertex of the skull. The patient was an uncontrolled diabetic and had systemic conditions like chronic obstructive pulmonary disease and chronic kidney disease. A CT scan revealed a collection along the infratemporal space extending into the masticatory space. Routine investigations, blood culture sensitivity, were sent, which revealed the presence of Burkholderia pseudomallei sensitive to ceftazidime and imipenem. Under antibiotic coverage, the treatment was initiated, incision and drainage were done to reduce the bacterial load. However, the patient was lost to underlying systemic conditions and septic shock.

  • Infections
  • Diabetes
  • Medical management

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  • Contributors NS—contributed by operating the patient and involved in patient management. Also approved the final draft. AK—contributed by operating the patient and involved in patient management. Also edited the draft and approved the final draft. SM—contributed by collecting patient data and prepared the initial draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.