Solid Organ Abscess by Melioidosis: An Emerging Infection Among Diabetics in Odisha, India

Melioidosis is an infection in tropical regions, caused by Gram-negative bacillus Burkholderia pseudomallei and carries very high case fatality rates. Diabetes mellitus is a major risk factor for melioidosis, and Odisha with its current trends in urban prevalence of diabetes and a tropical coastal climate seems to be emerging as a hub of melioidosis. We herein describe two cases of melioidosis encountered within a month. Case 1 is a 35-year-old male recently diagnosed with diabetes, presenting with fever and altered sensorium for 5 days. Case 2 is a 40-year-old female who complained of fever, cough, and generalised weakness for 2 months, and was subsequently found to be diabetic on routine investigations. Both the patients were subjected to imaging modalities which showed solid organ (liver and spleen) abscesses. On further investigations, Burkholderia pseudomallei was isolated from their blood cultures. Diagnosis of such cases within a short period of time points to the fact that Odisha indeed serves as a hidden hotspot of melioidosis. The case report throws light on the importance of early diagnosis and treatment of melioidosis, which is under-reported in the state, and it also aims to impress upon physicians to have a strong clinical suspicion so as to decrease the mortality associated this neglected tropical disease.