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Critical approach to atypical spectrum of melioidosis: a case-series based literature review
  1. Akhya Sharma1,
  2. Zubin Mahajan2,
  3. Sharath P Madhyastha3 and
  4. Vishal Mehta1
  1. 1Internal Medicine, Kasturba Medical College Manipal, Manipal, Karnataka, India
  2. 2Internal Medicine, Loyola Medicine MacNeal Hospital, Berwyn, Illinois, USA
  3. 3Internal Medicine, Manipal Academy of Higher Education, Kasturba Medical College Manipal, Manipal, Karnataka, India
  1. Correspondence to Dr Akhya Sharma; sharmaakhya{at}


Melioidosis is an emerging infectious disease with highest predominance in Southeast Asia, but it has a significantly lower incidence across other parts of the globe. The most common systemic involvement seen in melioidosis is pulmonary, followed by multiple visceral and cutaneous abscesses. Infrequently, melioidosis manifests with atypical presentations such as spontaneous bacterial peritonitis (SBP), acute pyogenic meningitis or septic arthritis. Our primary case discusses an extremely rare presentation of melioidosis with SBP. There have not been any cases of SBP reported secondary to melioidosis infection. The second case exhibits development of acute pyogenic meningitis from haematogenous dissemination of this organism, while the final case demonstrates musculoskeletal melioidosis as an uncommon presentation. Of note, this case series also discusses the guidelines of management of melioidosis and illustrates the tremendous impact of appropriate and timely antibiotic therapy on mortality and morbidity secondary to melioidosis.

  • Infections
  • Infectious diseases
  • Bone and joint infections
  • Meningitis
  • Infection (neurology)

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  • Correction notice The article has been corrected since it is published. The affilition 2 has been updated.

  • Contributors AS and ZM wrote the draft of the manuscript. The manuscript was critically reviewed by AS, ZM, VM and SM and important editing and additions were made to include essential intellectual components. The patient was under the care of SM. SM and AS were involved actively in the patient management. All authors contributed to the literature review and approved the final manuscript for submission.

  • 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.