Central nervous system melioidosis in systemic lupus erythematosus: A clinical vignette
Lay Hock Cheok,
Andy Sing Ong Tang,
Samuel Desmond,
Yi-Li Wong,
Yaw Kiet Cheong,
Say Chiew Ng,
Wee Mee Cheng,
Hock Hin Chua,
Cheng Lay Teh
Affiliations
Lay Hock Cheok
Department of Internal Medicine, Miri Hospital, Sarawak, Ministry of Health, Malaysia; Correspondence to: Department of Internal Medicine, Miri Hospital, Jalan Cahaya, 98000 Miri, Sarawak, Malaysia.
Andy Sing Ong Tang
Department of Internal Medicine, Miri Hospital, Sarawak, Ministry of Health, Malaysia
Samuel Desmond
Department of Internal Medicine, Miri Hospital, Sarawak, Ministry of Health, Malaysia
Yi-Li Wong
Department of Radiology, Miri Hospital, Sarawak, Ministry of Health, Malaysia
Yaw Kiet Cheong
Rheumatology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
Say Chiew Ng
Department of Internal Medicine, Miri Hospital, Sarawak, Ministry of Health, Malaysia
Wee Mee Cheng
Department of Internal Medicine, Miri Hospital, Sarawak, Ministry of Health, Malaysia
Hock Hin Chua
Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
Cheng Lay Teh
Rheumatology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
Central nervous system melioidosis is an uncommon presentation of melioidosis infection. We report a case of a disseminated melioidosis infection with central nervous system, pulmonary, spleen, bone and cutaneous involvement in a patient with underlying systemic lupus erythematous. The diagnosis was confirmed based on positive blood and cerebrospinal fluid cultures coupled with radiological findings. Agriculture contact and underlying immunocompromised state were the predisposing risk factors for melioidosis infection in this case. Our patient was successfully treated with 10 weeks of intensive antibiotics therapy and 1 year of eradication antibiotics therapy with significant clinical and radiological improvement.
