Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 21 , ISSUE 6 ( 2017 ) > List of Articles


Melioidosis: An emerging infection with fatal outcomes

Arun Kumar Daniel, S. Nandini, M. A. Thirunarayan

Keywords : Burkholderia pseudomallei, melioidosis, septic arthritis, septic shock

Citation Information : Daniel AK, Nandini S, Thirunarayan MA. Melioidosis: An emerging infection with fatal outcomes. Indian J Crit Care Med 2017; 21 (6):397-400.

DOI: 10.4103/ijccm.IJCCM_122_17

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2017; The Author(s).


According to the Centers for Disease Control and Prevention, from being nonendemic for melioidosis, India has now become endemic for the disease since 2012. Until then, melioidosis cases were being reported sporadically from India. There have been isolated case reports from few states across the country for the past few years. Most of the times, Burkholderia pseudomallei may be misreported as Pseudomonas species, especially in resource-poor laboratories. Due to its varied clinical presentation, the specific clinical diagnosis can be difficult, thereby making laboratory diagnosis mandatory. This could make a huge impact on patient care as this organism has a different treatment protocol as well as virulence determinants which influence the course of management. Although known for its endemicity in Australia, Thailand, and other Southeast Asian countries, B. pseudomallei has emerged in new areas such as India, Southern China, Brazil, and Malawi. We present a rare case of melioidosis with rapid disease progression to fatal outcome from Chennai, South India.

PDF Share
  1. Morse SS. Factors in the emergence of infectious diseases. Emerg Infect Dis 1995;1:7-15.
  2. Cheng AC, Currie BJ. Melioidosis: Epidemiology, pathophysiology, and management. Clin Microbiol Rev 2005;18:383-416.
  3. Vidyalakshmi K, Shrikala B, Bharathi B, Suchitra U. Melioidosis: An under-diagnosed entity in Western coastal India: A clinico-microbiological analysis. Indian J Med Microbiol 2007;25:245-8.
  4. Roy PP, Agarwala A, Sarkar SK, Mandal A. PUO with multiple abscesses due to Burkholderia pseudomallei: A case report. Int J Res Med Sci 2015;3:2506-9.
  5. Pandey V, Rao SP, Rao S, Acharya KK, Chhabra SS. Burkholderia pseudomallei musculoskeletal infections (melioidosis) in India. Indian J Orthop 2010;44:216-20.
  6. Melikyan G, Badawi M, Akhtar N, Elsetouhy AH. Case of paraspinal collection due to Burkholderia pseudomallei. BMJ Case Rep 2013;2013. pii: Bcr2013201447.
  7. Limmathurotsakul D, Golding N, Dance DA, Messina JP, Pigott DM, Moyes CL, et al. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 2016;1:15008.
  8. Hassan MR, Pani SP, Peng NP, Voralu K, Vijayalakshmi N, Mehanderkar R, et al. Incidence, risk factors and clinical epidemiology of melioidosis: A complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia. BMC Infect Dis 2010;10:302.
  9. Gopalakrishnan R, Sureshkumar D, Thirunarayan MA, Ramasubramanian V. Melioidosis: An emerging infection in India. J Assoc Physicians India 2013;61:612-4.
  10. Shetty RP, Mathew M, Smith J, Morse LP, Mehta JA, Currie BJ. Management of melioidosis osteomyelitis and septic arthritis. Bone Joint J 2015;97-B:277-82.
  11. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. CLSI Supplement M100S. 26th ed., Vol. 26. Wayne, PA: Clinical and Laboratory Standards Institute; 2016. p. 216.
  12. Mandell L, Bennett E, Dollin R. Burkholderia pseudomallei and Burkholderia mallei: Melioidosis and glanders. In: Krehling H, editor. Principles and Practice of Infectious Diseases. 7th ed. Churchill Livingstone: Elsevier publishers; 2010. p. 2869-78.
  13. Dance D. Treatment and prophylaxis of melioidosis. Int J Antimicrob Agents 2014;43:310-8.
  14. Cheng AC, Fisher DA, Anstey NM, Stephens DP, Jacups SP, Currie BJ. Outcomes of patients with melioidosis treated with meropenem. Antimicrob Agents Chemother 2004;48:1763-5.
  15. Laowansiri P, Shah S, Kiratisin P, Apisarnthanarak A. A role for carbapenem in the treatment of melioidosis in developing countries? Int J Infect Dis 2009;13:e331-2.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.