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 Melioidosis is caused by a Gramnegative bacteria known as Burkholderia pseudomallei. Clinical manifestation of the disease is unspecific, leading to wrong diagnosis and delayed in administration of appropriate antibiotics. Case Report: This case reported an atypical presentation of melioidosis in a 45-year-old Malay lady with underlying asthma and hypertension who presented with generalized abdominal pain for 14 days. A few days before admission she developed high grade fever and jaundice. She was initially treated as ascending cholangitis. The diagnosis was changed to disseminated melioidosis after computed tomography (CT) scan findings and isolation of B. pseudomallei from the blood culture. She was treated with antibiotics according to the melioidosis regime and responded well to the therapy. Conclusion: Acute cholangitis or cholecystitis is a rare presentation of melioidosis. High degree of suspicion is very crucial in a patient presented with any severe illness especially in an endemic area.

Melioidosis presented as severe acute cholangitis: A rare presentation