Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma
Melioidosis, caused by Burkholderia pseudomallei, is an uncommon but serious infection in children and is predominantly reported in endemic regions, such as Southeast Asia and northern Australia. Melioidosis is known for its varied clinical spectrum of manifestation, which can range from mild to lif...
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Cairo University, Faculty of Medicine, Department of Pediatrics
2025-07-01
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| Series: | Pediatric Sciences Journal |
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| Online Access: | https://cupsj.journals.ekb.eg/article_436674_26cc10df6e06821ede35bb3cd0b8c43f.pdf |
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| author | Pragathesh Palaniappan Reema Dakua Ritu Singh Vinita Shaju Sravani Tera |
| author_facet | Pragathesh Palaniappan Reema Dakua Ritu Singh Vinita Shaju Sravani Tera |
| author_sort | Pragathesh Palaniappan |
| collection | DOAJ |
| description | Melioidosis, caused by Burkholderia pseudomallei, is an uncommon but serious infection in children and is predominantly reported in endemic regions, such as Southeast Asia and northern Australia. Melioidosis is known for its varied clinical spectrum of manifestation, which can range from mild to life-threatening presentations. Although pneumonia and septicemia are the most frequent presentations, cutaneous manifestations can also occur. These skin manifestations often mimic other tropical diseases, making diagnosis challenging, especially in resource-limited settings. Here, we describe a case of an infant from Andaman and Nicobar Islands, India, who presented with fever, respiratory distress, purulent ear discharge, diarrhea and an eschar-like skin lesion resembling scrub typhus. Given the initial clinical presentation, rickettsial infections were considered; however, blood culture confirmed Burkholderia pseudomallei as the causative agent. The patient was successfully managed with an extended course of intravenous meropenem and oral trimethoprim- sulfamethoxazole, which led to full recovery. This case underscores the importance of recognizing melioidosis as a differential diagnosis in endemic areas, particularly in children presenting with atypical skin lesions mimicking other febrile illnesses. Enhanced clinical awareness, coupled with improved diagnostic capabilities and timely initiation of appropriate antimicrobial therapy, is crucial for the effective management of melioidosis. This is particularly vital in regions where the disease remains underreported, and its true burden may be underestimated. |
| format | Article |
| id | doaj-art-5efa8858d42041e59c36e15bb30f1470 |
| institution | Kabale University |
| issn | 2805-279X 2682-3985 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Cairo University, Faculty of Medicine, Department of Pediatrics |
| record_format | Article |
| series | Pediatric Sciences Journal |
| spelling | doaj-art-5efa8858d42041e59c36e15bb30f14702025-08-20T03:31:26ZengCairo University, Faculty of Medicine, Department of PediatricsPediatric Sciences Journal2805-279X2682-39852025-07-01529910310.21608/cupsj.2025.372348.1163Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic DilemmaPragathesh Palaniappan0https://orcid.org/0000-0002-7303-6640Reema Dakua1https://orcid.org/0009-0005-4309-4021Ritu Singh2https://orcid.org/0000-0003-3614-9408Vinita Shaju3https://orcid.org/0009-0002-2169-5406Sravani Tera4https://orcid.org/0009-0001-1389-3712Department of Pediatrics, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Sri Vijaya Puram, IndiaDepartment of Pediatrics, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Sri Vijaya Puram, IndiaDepartment of Pediatrics, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Sri Vijaya Puram, IndiaDepartment of Pediatrics, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Sri Vijaya Puram, IndiaDepartment of Pediatrics, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Sri Vijaya Puram, IndiaMelioidosis, caused by Burkholderia pseudomallei, is an uncommon but serious infection in children and is predominantly reported in endemic regions, such as Southeast Asia and northern Australia. Melioidosis is known for its varied clinical spectrum of manifestation, which can range from mild to life-threatening presentations. Although pneumonia and septicemia are the most frequent presentations, cutaneous manifestations can also occur. These skin manifestations often mimic other tropical diseases, making diagnosis challenging, especially in resource-limited settings. Here, we describe a case of an infant from Andaman and Nicobar Islands, India, who presented with fever, respiratory distress, purulent ear discharge, diarrhea and an eschar-like skin lesion resembling scrub typhus. Given the initial clinical presentation, rickettsial infections were considered; however, blood culture confirmed Burkholderia pseudomallei as the causative agent. The patient was successfully managed with an extended course of intravenous meropenem and oral trimethoprim- sulfamethoxazole, which led to full recovery. This case underscores the importance of recognizing melioidosis as a differential diagnosis in endemic areas, particularly in children presenting with atypical skin lesions mimicking other febrile illnesses. Enhanced clinical awareness, coupled with improved diagnostic capabilities and timely initiation of appropriate antimicrobial therapy, is crucial for the effective management of melioidosis. This is particularly vital in regions where the disease remains underreported, and its true burden may be underestimated.https://cupsj.journals.ekb.eg/article_436674_26cc10df6e06821ede35bb3cd0b8c43f.pdfmelioidosisburkholderia pseudomalleipediatric infectionseschar |
| spellingShingle | Pragathesh Palaniappan Reema Dakua Ritu Singh Vinita Shaju Sravani Tera Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma Pediatric Sciences Journal melioidosis burkholderia pseudomallei pediatric infections eschar |
| title | Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma |
| title_full | Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma |
| title_fullStr | Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma |
| title_full_unstemmed | Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma |
| title_short | Melioidosis in an infant presenting with Eschar-like lesion: A Diagnostic Dilemma |
| title_sort | melioidosis in an infant presenting with eschar like lesion a diagnostic dilemma |
| topic | melioidosis burkholderia pseudomallei pediatric infections eschar |
| url | https://cupsj.journals.ekb.eg/article_436674_26cc10df6e06821ede35bb3cd0b8c43f.pdf |
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