Open AccessSplenic granuloma: Melioidosis or Tuberculosis?
Author(s) -
Fibi Ninan,
Ajay Kumar Mishra,
Ajoy Oommen John,
Ramya Iyadurai
Publication year - 2018
Publication title -
journal of family medicine and primary care
Language(s) - Uncategorized
Resource type - Journals
eISSN - 2278-7135
pISSN - 2249-4863
DOI - 10.4103/jfmpc.jfmpc_171_17
Subject(s) - melioidosis , medicine , burkholderia pseudomallei , fulminant , tuberculosis , ceftazidime , granuloma , meropenem , antibiotics , dapsone , dermatology , surgery , intensive care medicine , immunology , pathology , microbiology and biotechnology , antibiotic resistance , pseudomonas aeruginosa , genetics , bacteria , biology
Melioidosis well known as a 'great mimicker' is caused by Burkholderia pseudomallei. Even though majority of the patients present with acute infection, around 18 % can present as chronic infection. These latent foci of infection may reactivate to cause fulminant infection at a later date. Due to lack of clinical suspicion and good laboratory facility latent infections are often misdiagnosed and treated as tuberculosis. Chronic splenic granuloma is a rare manifestation of Melioidosis . Deep seated abscess requires atleast 4 weeks of intensive treatment with intravenous antibiotics. Ceftazidime , the drug of choice for melioidosis can cause drug induced thrombocytopenia. Simultaneous use of diclofenac may potentiate this phenomenon. Treatment with meropenem may be life saving in such situitations.