Melioidosis: A New Emerging Infection in West Coastal Maharashtra

SUMEDH SUDHAKAR LOKAPURE,
AJAY GOVIND KENI,
AJIT VINAYAK KULKRANI,
Preetham Napa,*
Amol Kulkarni,
Sanjay Ram Deshpande,
Kaustubh Machnurkar,
Gopal Wasgaonkar

Abstract

Background/Objective: Melioidosis is a zoonotic infectious disease caused by a gram-negative bacterium Burkhloderia pseudomallei. It is an endemic disease in Southeast Asia and Northern Australia, but under reported from India. This study was conducted to determine the geographical epidemiology, risk factors, clinical presentations associated with melioidosis. Methods: It is retrospective study of six culture proven cases of Melioidosis from a tertiary care hospital. Results: The six cases of melioidosis were from same geographical location from western coast of Maharashtra. The age group ranged from 3 years to 55 years but more predominant group was within 30-to-50-years. All were males (100%), no female patient was affected. Majority of cases were presented to the hospital in rainy season, from June to September, coincides with season of heavy rainfall. Alcoholism (83.33%) and diabetes mellitus (66.66%) were major risk factors involved. Fever (100%) was most common presenting symptoms. The organ space abscess (50%) involving lymph node, liver and spleen were common followed by disseminated disease and pulmonary melioidosis. All patients were treated with ß-lactam antibiotics as intensive therapy followed by oral cotrimoxazole as eradication therapy. Conclusion: Melioidosis is an emerging infection in India specially in the coastal region with very heavy rainfalls. Male gender is prone to develop the infection with diabetes and alcoholism are additional risk factors. The clinical presentation may vary from localised organ space abscess to septic shock with high mortality. The accurate diagnosis and prompt treatment play key role in managing melioidosis.