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A rare case of melioidosis presenting as myositis in Sri Lanka

BACKGROUND: Melioidosis caused by Burkholderia pseudomallei is an emerging infection in Sri Lanka with a high case fatality rate. The disease usually manifests as pneumonia, however multisystem involvement is common. Myositis is an extremely rare occurrence and this is the only documented case where...

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Autores principales: Vithana, Sanura Malinda Pallegoda, Chathuranga, Liyanage Sashika, Jayasinghe, Saman, Udayakumara, Edippuli Arachchige Don
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202086/
https://www.ncbi.nlm.nih.gov/pubmed/35705895
http://dx.doi.org/10.1186/s12879-022-07515-y
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author Vithana, Sanura Malinda Pallegoda
Chathuranga, Liyanage Sashika
Jayasinghe, Saman
Udayakumara, Edippuli Arachchige Don
author_facet Vithana, Sanura Malinda Pallegoda
Chathuranga, Liyanage Sashika
Jayasinghe, Saman
Udayakumara, Edippuli Arachchige Don
author_sort Vithana, Sanura Malinda Pallegoda
collection PubMed
description BACKGROUND: Melioidosis caused by Burkholderia pseudomallei is an emerging infection in Sri Lanka with a high case fatality rate. The disease usually manifests as pneumonia, however multisystem involvement is common. Myositis is an extremely rare occurrence and this is the only documented case where the initial presentation of melioidosis has been myositis and later complicated to myonecrosis. CASE PRESENTATION: A 45-year-old gentleman with pre-existing diabetes presented with a tender, right thigh lump for 1 week duration without any history of trauma or infection. Investigations revealed neutrophil leukocytosis, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels whilst ultrasonography showed focal myositis of right quadriceps. The patient went into sepsis amidst antibacterial treatment which warranted urgent surgery. At surgery, a large intramuscular abscess with myonecrosis was observed within vastus medialis which was completely drained and pus was taken for culture which eventually isolated Burkholderia pseudomallei. Melioidosis was diagnosed and intravenous meropenem was prescribed for 3 weeks. Following complete recovery, the patient was discharged on doxycycline and trimethoprim sulfamethoxazole for 3 months. CONCLUSIONS: Melioidosis, an endemic disease in south east Asia and northern Australia, is an emerging infection in Sri Lanka. Myositis is a rare presentation of the disease that can lead to myonecrosis and abscess formation which can cause rapid disease escalation and sepsis. Early surgical intervention may be life-saving in such cases where antibiotic therapy alone may not suffice.
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spelling pubmed-92020862022-06-17 A rare case of melioidosis presenting as myositis in Sri Lanka Vithana, Sanura Malinda Pallegoda Chathuranga, Liyanage Sashika Jayasinghe, Saman Udayakumara, Edippuli Arachchige Don BMC Infect Dis Case Report BACKGROUND: Melioidosis caused by Burkholderia pseudomallei is an emerging infection in Sri Lanka with a high case fatality rate. The disease usually manifests as pneumonia, however multisystem involvement is common. Myositis is an extremely rare occurrence and this is the only documented case where the initial presentation of melioidosis has been myositis and later complicated to myonecrosis. CASE PRESENTATION: A 45-year-old gentleman with pre-existing diabetes presented with a tender, right thigh lump for 1 week duration without any history of trauma or infection. Investigations revealed neutrophil leukocytosis, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels whilst ultrasonography showed focal myositis of right quadriceps. The patient went into sepsis amidst antibacterial treatment which warranted urgent surgery. At surgery, a large intramuscular abscess with myonecrosis was observed within vastus medialis which was completely drained and pus was taken for culture which eventually isolated Burkholderia pseudomallei. Melioidosis was diagnosed and intravenous meropenem was prescribed for 3 weeks. Following complete recovery, the patient was discharged on doxycycline and trimethoprim sulfamethoxazole for 3 months. CONCLUSIONS: Melioidosis, an endemic disease in south east Asia and northern Australia, is an emerging infection in Sri Lanka. Myositis is a rare presentation of the disease that can lead to myonecrosis and abscess formation which can cause rapid disease escalation and sepsis. Early surgical intervention may be life-saving in such cases where antibiotic therapy alone may not suffice. BioMed Central 2022-06-15 /pmc/articles/PMC9202086/ /pubmed/35705895 http://dx.doi.org/10.1186/s12879-022-07515-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Vithana, Sanura Malinda Pallegoda
Chathuranga, Liyanage Sashika
Jayasinghe, Saman
Udayakumara, Edippuli Arachchige Don
A rare case of melioidosis presenting as myositis in Sri Lanka
title A rare case of melioidosis presenting as myositis in Sri Lanka
title_full A rare case of melioidosis presenting as myositis in Sri Lanka
title_fullStr A rare case of melioidosis presenting as myositis in Sri Lanka
title_full_unstemmed A rare case of melioidosis presenting as myositis in Sri Lanka
title_short A rare case of melioidosis presenting as myositis in Sri Lanka
title_sort rare case of melioidosis presenting as myositis in sri lanka
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202086/
https://www.ncbi.nlm.nih.gov/pubmed/35705895
http://dx.doi.org/10.1186/s12879-022-07515-y
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