Melioidosis with a Pericardial Effusion, which Relapsed as a Chest Wall Abscess: A Rare Presentation

Abstract

Melioidosis, which is caused by a soil saprophyte, Burkholderia pseudomallei, is most prevalent in the south–west coast of India. Although it is frequently seen in immunocompromised patients, melioidosis can occur in apparently normal individuals. Melioidosis can involve almost any organ. A relapse of melioidosis is usually associated with a poor adherence to the eradication therapy, a multifocal involvement and bacteraemia. A relapsing melioidosis is usually known to follow a similar pattern of organ involvement in the first and second episodes of the infection. We are discussing here, a rare case of melioidosis in a 38-year-old construction-worker, with no risk factors, who presented initially with a pericardial effusion. It relapsed 6 months after he completed the prescribed eradication therapy for 3 months, as an anterior chest wall abscess. The author recommends a high index of suspicion for the relapsed melioidosis cases, inspite of the primary episode being non-bacteraemic and compliant with the recommended therapy, in order to avoid further complications.

Keywords

• melioidosis
• relapse
• pericardial effusion
• chest wall abscess