Burkholderia pseudomallei also called as pseudomonas pseudomallei is an intracellular gram negative bipolar staining aerobic motile shaped rod with a safety pin appearance when seen microscopically measuring 25 micro metre in length and 0.4 -0.8 micro metre in diameter . It is capable of self population using flagella. In vitro , it requires a temperature of 40 degree and grows in an acidic environment fermenting glucose and galactose . It produces both exotoxin and endotoxins. It causes polymerization of actin and spreads cell to cell causing cell fusion and formation of multinucleated giant cells .It is usually diagnosed using latex agglutination and rapid immunofluorescence technique. Molecular level diagnosis can be done using FISH and
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Meliodosis is found to be endemic in south eastern parts of asia and also northern Australia. Twenty persent of human sepsis cases recoreded in northern Australia is mainly attributed to meliodosis. In india the disease is prevalent all around the country but its less reported as well as underdiagnosed. There are few case reports from vellore district as well from kerala and Karnataka. High risk groups include military personnels , adventure travellers , ecotourists and agricultural and construction workers. It is mainly spread by percutaneous inoculation but inhalational route of spreading is also documented. The disease has an incubation period of 9 -21 days and its highly seasonal with 75 % of cases occurring during the monsoon rainfall season. It is also called as “vietnamesse time bomb “as it was isolated from the military troops in the endemic region with a latency period of 62 …show more content…
His vitals was stable and general examination was normal and crepitations were noted side of lung and chest x ray revealed right upper zone opacity with hilar prominence. He was anemic with elevated ESR and total wbc counts. He was suspected for pneumonia query pulmonary tuberculosis. He was prescribed antipyretics and was started on co amoxy clav on day 3 . Mantoux was negative and sputum AFB Samples were negative and ultrasound abdomen revealed hepatomegaly and splenimegaly with multiple hypoechoic lesions. Right kidney revealed staghorn calculus. On day 7 sputum culture was positive for burkholderia pseudomallei and ct scan revealed right sided consolidation with cavity formation with pseudoaneurysm formation which is very rare signifying meliodosis can also cause arteritis . So patient was started on ceftazidie 2g iv eight hourly along with cotrimoxazole . After two weeks hemoptysis stopped and patient condition improved .repeat ct scan revealed no contrast opacification of pseudoaneurysm and decrease in consolidation and size of cavity in right apical segment.Patient was advised ceftazidie oral tablet for 3 weeks along with cotrimoxazole and other concomitant medications . patient was discharged and follow up after 3 weeks patient was
Meliodosis is found to be endemic in south eastern parts of asia and also northern Australia. Twenty persent of human sepsis cases recoreded in northern Australia is mainly attributed to meliodosis. In india the disease is prevalent all around the country but its less reported as well as underdiagnosed. There are few case reports from vellore district as well from kerala and Karnataka. High risk groups include military personnels , adventure travellers , ecotourists and agricultural and construction workers. It is mainly spread by percutaneous inoculation but inhalational route of spreading is also documented. The disease has an incubation period of 9 -21 days and its highly seasonal with 75 % of cases occurring during the monsoon rainfall season. It is also called as “vietnamesse time bomb “as it was isolated from the military troops in the endemic region with a latency period of 62 …show more content…
His vitals was stable and general examination was normal and crepitations were noted side of lung and chest x ray revealed right upper zone opacity with hilar prominence. He was anemic with elevated ESR and total wbc counts. He was suspected for pneumonia query pulmonary tuberculosis. He was prescribed antipyretics and was started on co amoxy clav on day 3 . Mantoux was negative and sputum AFB Samples were negative and ultrasound abdomen revealed hepatomegaly and splenimegaly with multiple hypoechoic lesions. Right kidney revealed staghorn calculus. On day 7 sputum culture was positive for burkholderia pseudomallei and ct scan revealed right sided consolidation with cavity formation with pseudoaneurysm formation which is very rare signifying meliodosis can also cause arteritis . So patient was started on ceftazidie 2g iv eight hourly along with cotrimoxazole . After two weeks hemoptysis stopped and patient condition improved .repeat ct scan revealed no contrast opacification of pseudoaneurysm and decrease in consolidation and size of cavity in right apical segment.Patient was advised ceftazidie oral tablet for 3 weeks along with cotrimoxazole and other concomitant medications . patient was discharged and follow up after 3 weeks patient was