Tuberculosis and Melioidosis at Distinct Sites Occurring Simultaneously

RATIONALE: Both tuberculosis and melioidosis are commonly encountered infectious diseases in South East Asia. However, these conditions occur commonly in isolation, cases of coinfection of Mycobacterium tuberculosis and Burkholderia pseudomallei are rare. These cases report of the isolation of both organisms concomitantly in a single disease site. We report the first case of concomitant infection at distinct noncontiguous sites. PATIENT CONCERNS: A 64-year-old man, with chronic alcohol consumption, presented with a month long history of left-sided abdominal pain, as well as significant weight loss and fever prior to the onset of abdominal pain. DIAGNOSIS: Disseminated tuberculosis with pulmonary and gastrointestinal involvement and a splenic abscess due to melioidosis. INTERVENTIONS: The patient was treated concomitantly for pulmonary and gastrointestinal tuberculosis, as well as a splenic abscess due to melioidosis. OUTCOMES: The patient is reported to be well, with resolution of symptoms, as well as radiological resolution of the splenic abscess. LESSONS: Both melioidosis and tuberculosis can present with a similar clinical picture, and coinfections are rare. Hence, increased awareness among clinicians and microbiologists can help in diagnosing both diseases even when it is not clinically apparent.