Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn

Introduction. Melioidosis is a bacterial infection caused by a Gram-negative bacillus Burkholderia pseudomallei, prevalent in Southeast Asia and Northern Australia. Sri Lanka is situated in the endemic belt of melioidosis. Melioidosis has a wide spectrum of clinical presentations and results in high...

Full description

Saved in:
Bibliographic Details
Main Authors: Dinuka S Warapitiya, Shyama Subasinghe, Rukshanie Frances de Silva, Dadallage Lalitha Piyarisi, Kushlani Jayatilleke
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2021/5563214
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849686670558887936
author Dinuka S Warapitiya
Shyama Subasinghe
Rukshanie Frances de Silva
Dadallage Lalitha Piyarisi
Kushlani Jayatilleke
author_facet Dinuka S Warapitiya
Shyama Subasinghe
Rukshanie Frances de Silva
Dadallage Lalitha Piyarisi
Kushlani Jayatilleke
author_sort Dinuka S Warapitiya
collection DOAJ
description Introduction. Melioidosis is a bacterial infection caused by a Gram-negative bacillus Burkholderia pseudomallei, prevalent in Southeast Asia and Northern Australia. Sri Lanka is situated in the endemic belt of melioidosis. Melioidosis has a wide spectrum of clinical presentations and results in high mortality rates in severe infection. Case Report. We report a 54-year-old previously healthy Sri Lankan farmer who presented with septicemia following a cut injury to the right leg while working in a paddy field. Initially, he had mild wound sepsis, and later, his condition deteriorated rapidly. The patient required organ support later for cardiovascular instability, acute liver failure, acute kidney injury, acute respiratory distress syndrome, and coagulopathy. The patient’s blood culture was negative on the admission day, and the repeated blood culture taken at the ICU was contaminated with a commensal flora initially and later isolated Burkholderia pseudomallei. Although wound swab culture taken on the first day isolated an organism, it took six days to identify it as Burkholderia pseudomallei. The patient succumbed to severe melioidosis leading to a severe sepsis and multiorgan failure in spite of treatment with meropenem. Conclusion. This case report highlights the importance of considering melioidosis as a differential diagnosis when a patient comes with risk factors for melioidosis.
format Article
id doaj-art-bfd5060dacc441e1809128cc5ca69c6b
institution DOAJ
issn 1687-9627
1687-9635
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series Case Reports in Medicine
spelling doaj-art-bfd5060dacc441e1809128cc5ca69c6b2025-08-20T03:22:38ZengWileyCase Reports in Medicine1687-96271687-96352021-01-01202110.1155/2021/55632145563214Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to LearnDinuka S Warapitiya0Shyama Subasinghe1Rukshanie Frances de Silva2Dadallage Lalitha Piyarisi3Kushlani Jayatilleke4Post Graduate Institute of Medicine, University of Colombo, Colombo, Sri LankaSri Jayewardenepura General Hospital, Nugegoda, Colombo, Sri LankaPost Graduate Institute of Medicine, University of Colombo, Colombo, Sri LankaSri Jayewardenepura General Hospital, Nugegoda, Colombo, Sri LankaSri Jayewardenepura General Hospital, Nugegoda, Colombo, Sri LankaIntroduction. Melioidosis is a bacterial infection caused by a Gram-negative bacillus Burkholderia pseudomallei, prevalent in Southeast Asia and Northern Australia. Sri Lanka is situated in the endemic belt of melioidosis. Melioidosis has a wide spectrum of clinical presentations and results in high mortality rates in severe infection. Case Report. We report a 54-year-old previously healthy Sri Lankan farmer who presented with septicemia following a cut injury to the right leg while working in a paddy field. Initially, he had mild wound sepsis, and later, his condition deteriorated rapidly. The patient required organ support later for cardiovascular instability, acute liver failure, acute kidney injury, acute respiratory distress syndrome, and coagulopathy. The patient’s blood culture was negative on the admission day, and the repeated blood culture taken at the ICU was contaminated with a commensal flora initially and later isolated Burkholderia pseudomallei. Although wound swab culture taken on the first day isolated an organism, it took six days to identify it as Burkholderia pseudomallei. The patient succumbed to severe melioidosis leading to a severe sepsis and multiorgan failure in spite of treatment with meropenem. Conclusion. This case report highlights the importance of considering melioidosis as a differential diagnosis when a patient comes with risk factors for melioidosis.http://dx.doi.org/10.1155/2021/5563214
spellingShingle Dinuka S Warapitiya
Shyama Subasinghe
Rukshanie Frances de Silva
Dadallage Lalitha Piyarisi
Kushlani Jayatilleke
Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
Case Reports in Medicine
title Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
title_full Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
title_fullStr Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
title_full_unstemmed Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
title_short Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
title_sort severe sepsis with multiorgan failure due to melioidosis a lesson to learn
url http://dx.doi.org/10.1155/2021/5563214
work_keys_str_mv AT dinukaswarapitiya severesepsiswithmultiorganfailureduetomelioidosisalessontolearn
AT shyamasubasinghe severesepsiswithmultiorganfailureduetomelioidosisalessontolearn
AT rukshaniefrancesdesilva severesepsiswithmultiorganfailureduetomelioidosisalessontolearn
AT dadallagelalithapiyarisi severesepsiswithmultiorganfailureduetomelioidosisalessontolearn
AT kushlanijayatilleke severesepsiswithmultiorganfailureduetomelioidosisalessontolearn