UNUSUALPRESENTATIONOFMELIOIDOSIS:A CASEREPORT HIGHLIGHTINGCLINICALANDMICROBIOLOGICAL CHALLENGES
IntroductionMelioidosis is an emerging infectious disease caused by Burkholderia pseudomallei, commonly seen in tropical regions and increasingly reported in India. It presents with a wide spectrum of clinical manifestations and often mimics other infectious or malignantconditions, leading to diagnostic challenges, especially in immunocompromisedindividuals.Case PresentationA 62-year-old male, a known case of non-small cell lung carcinoma post chemoradiotherapy, presented with left upper abdominal pain and intermittent fever for two months to our multispecialty hospital in South India. He had underlying diabetes mellitus. Imaging revealed hepatosplenomegaly with a splenic abscess. Aspiration of the collection showed neutrophilic predominance, and microbiological culture grew Burkholderia pseudomallei. Tuberculosis and malignancy were ruled out. The patient was diagnosed with melioidosis presenting as a splenic abscess without pulmonary involvement. He was treated with intravenous ceftazidime followed by oral cotrimoxazole, along with supportive care and glycemic control.ResultsThe patient showed significant clinical improvement with resolution of fever and stabilization of laboratory parameters. No complications were observed during hospitalization, and he was discharged in stable condition on prolonged eradication therapy.ConclusionThis case highlights an unusual extrapulmonary presentation of melioidosis in an immunocompromised host, emphasizing the importance of early microbiological diagnosis and targeted therapy. A high index of suspicion is essential to avoid misdiagnosis and ensure timely management.