Melioidosis: the great mimicker presenting as spondylodiscitis

Garg, Rahul and Shaw, Tushar and Bhat, Shyamasunder N and Mukhopadhyay, Chiranjay (2018) Melioidosis: the great mimicker presenting as spondylodiscitis. BMJ Case Report. pp. 1-4. ISSN 1757-790X

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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.

Item Type: Article
Subjects: Medicine > KMC Manipal > Microbiology
Medicine > KMC Manipal > Orthopaedics
Depositing User: KMC Library
Date Deposited: 21 Feb 2018 04:31
Last Modified: 21 Feb 2018 04:31
URI: http://eprints.manipal.edu/id/eprint/150616

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