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Case Report
Melioidosis presented as severe acute cholangitis: A rare presentation
1 MPath (Microbiology) Student, Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia
2 Infectious Disease Physician, Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia
3 Hospital USM, Health Campus, USM, 16150 Kubang Kerian, Kelantan, Malaysia
4 Medical Microbiologist, Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia
Address correspondence to:
Abdul Rahman Zaidah
Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan,
Malaysia
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Article ID: 101049Z01ST2019
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How to cite this article
Tajudin SM, Besari AM, Ismail N, Hassan SA, Zaidah AR. Melioidosis presented as severe acute cholangitis: A rare presentation. Int J Case Rep Images 2019;10:101049Z01ST2019.ABSTRACT
Introduction: 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.
Keywords: Burkholderia pseudomallei, Cholangitis, Melioidosis
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Acknowledgments
We thank the Management of the Hospital Universiti Sains Malaysia (USM), Kubang Kerian, Kelantan for granting the permission to the investigators to use patients’ medical record; space and assets belong to the hospital during the process of conducting the research.
Author ContributionsSyazwani Mohd Tajudin - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alwi Muhd Besari - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nabilah Ismail - Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Siti Asma' Hassan - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abdul Rahman Zaidah - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementNot applicable. All possible efforts have been made to protect the identity of the patient.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Syazwani Mohd Tajudin et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
