Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise

Introduction: Melioidosis, caused by the soil saprophyte B. pseudomallei, is a ‘neglected’ infectious disease in many Asian countries. It remained undiagnosed or misdiagnosed in India for long due to a lack of awareness and facilities to diagnose the disease; however, it is slowly gaining the statu...

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Main Authors: Rahul Garg, Tushar Shaw, Kalwaje E Vandana, Rahul Magazine, Chiranjay Mukhopadhyay
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2020-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12051
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author Rahul Garg
Tushar Shaw
Kalwaje E Vandana
Rahul Magazine
Chiranjay Mukhopadhyay
author_facet Rahul Garg
Tushar Shaw
Kalwaje E Vandana
Rahul Magazine
Chiranjay Mukhopadhyay
author_sort Rahul Garg
collection DOAJ
description Introduction: Melioidosis, caused by the soil saprophyte B. pseudomallei, is a ‘neglected’ infectious disease in many Asian countries. It remained undiagnosed or misdiagnosed in India for long due to a lack of awareness and facilities to diagnose the disease; however, it is slowly gaining the status of an emerging disease recently. The disease is well known as a great mimicker, as the presentations are very similar to many other tropical diseases, and more importantly, to tuberculosis . Methodology: A prospective observational study was conducted from January 2016 – December 2018 to find the occurance of melioidosis  in patients with ‘recurrent’ tuberculosis infection in a tertiary health care hospital from southern India. All suspected cases of recurrent tuberculosis were simultaneously tested for the presence of B. pseudomallei, and basic demographics and clinical details were documented. Result: Among 11,138 patients admitted with suspected tuberculosis infection, 586 (5.2%) patients were confirmed. There was recurrent Mycobacterium tuberculosis infection in 11/586 (1.8%) cases, and 7/586 (1.2%) had growth of B. pseudomallei in culture. Patients with melioidosis had either pulmonary involvement, or bone and joint infections and deep abscesses.  Uncontrolled diabetes mellitus was the major risk factor. Conclusion: The study foreshadows the need for prompt and accurate microbiological diagnosis along with a high index of suspicion from the clinicians in countries which are endemic for both melioidosis and tuberculosis, thus ameliorating the irrational anti-tuberculosis treatment.
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spelling doaj-art-923b2a4f875441a191885d35e0b9506e2025-08-20T02:16:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-03-01140310.3855/jidc.12051Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguiseRahul Garg0Tushar Shaw1Kalwaje E Vandana2Rahul Magazine3Chiranjay Mukhopadhyay4Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India - 576104Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India - 576104Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India - 576104Department of Pulmonary Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India – 576104Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India - 576104 Introduction: Melioidosis, caused by the soil saprophyte B. pseudomallei, is a ‘neglected’ infectious disease in many Asian countries. It remained undiagnosed or misdiagnosed in India for long due to a lack of awareness and facilities to diagnose the disease; however, it is slowly gaining the status of an emerging disease recently. The disease is well known as a great mimicker, as the presentations are very similar to many other tropical diseases, and more importantly, to tuberculosis . Methodology: A prospective observational study was conducted from January 2016 – December 2018 to find the occurance of melioidosis  in patients with ‘recurrent’ tuberculosis infection in a tertiary health care hospital from southern India. All suspected cases of recurrent tuberculosis were simultaneously tested for the presence of B. pseudomallei, and basic demographics and clinical details were documented. Result: Among 11,138 patients admitted with suspected tuberculosis infection, 586 (5.2%) patients were confirmed. There was recurrent Mycobacterium tuberculosis infection in 11/586 (1.8%) cases, and 7/586 (1.2%) had growth of B. pseudomallei in culture. Patients with melioidosis had either pulmonary involvement, or bone and joint infections and deep abscesses.  Uncontrolled diabetes mellitus was the major risk factor. Conclusion: The study foreshadows the need for prompt and accurate microbiological diagnosis along with a high index of suspicion from the clinicians in countries which are endemic for both melioidosis and tuberculosis, thus ameliorating the irrational anti-tuberculosis treatment. https://jidc.org/index.php/journal/article/view/12051MelioidosisTuberculosisBurkholderia pseudomalleitropical infectionrecurrenceIndia
spellingShingle Rahul Garg
Tushar Shaw
Kalwaje E Vandana
Rahul Magazine
Chiranjay Mukhopadhyay
Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise
Journal of Infection in Developing Countries
Melioidosis
Tuberculosis
Burkholderia pseudomallei
tropical infection
recurrence
India
title Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise
title_full Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise
title_fullStr Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise
title_full_unstemmed Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise
title_short Melioidosis In Suspected Recurrent Tuberculosis: A disease in disguise
title_sort melioidosis in suspected recurrent tuberculosis a disease in disguise
topic Melioidosis
Tuberculosis
Burkholderia pseudomallei
tropical infection
recurrence
India
url https://jidc.org/index.php/journal/article/view/12051
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