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Tuberculosis mimicked by melioidosis.
Int J Tuberc Lung Dis. 2008 Oct; 12(10):1209-15.IJ

Abstract

BACKGROUND

In regions endemic for tuberculosis (TB) such as India, presumptive anti-tuberculosis treatment is often prescribed. Melioidosis, caused by Burkholderia pseudomallei, is underdiagnosed in India, due to lack of awareness and a low index of suspicion.

SETTING

A tertiary care hospital in south India.

OBJECTIVE

To present our analysis of a series of 22 cases of suspected TB that was later confirmed as melioidosis.

DESIGN

Twenty-two patients with culture-proven melioidosis, who were initially given empirical anti-tuberculosis treatment, were retrospectively analysed regarding clinical presentation, laboratory findings and epidemiological features, with a view to determining any significant discriminatory parameter/s that would help distinguish the two diseases.

RESULTS

Eight cases mimicked pulmonary TB, five tubercular arthritis, three tubercular spondylitis, two tubercular lymphadenitis, two splenic abscess, and one each mimicked tubercular pericarditis and parotid abscess. Fever was the chief presenting complaint; all had high erythrocyte sedimentation rate (ESR) values (mean 111 mm +/- 23.7 SD); 15 (68.2%) had neutrophilic leuco-cytosis, 20 (90.9%) had diabetes mellitus. Subsequent to laboratory culture reports confirming melioidosis, appropriate treatment was instituted.

CONCLUSION

Fever in a diabetic patient with high ESR and neutrophilic leucocytosis should raise suspicion of melioidosis while instituting presumptive anti-tuberculosis treatment in areas where both diseases are prevalent.

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Authors+Show Affiliations

Vidyalakshmi K
Department of Microbiology, Kasturba Medical College, Mangalore, India. k.vidyalakshmi@lycos.com
Chakrapani M
No affiliation info available
Shrikala B
No affiliation info available
Damodar S
No affiliation info available
Lipika S
No affiliation info available
Vishal S
No affiliation info available

MeSH

AdolescentAdultAgedAntitubercular AgentsBurkholderia pseudomalleiChi-Square DistributionDiagnosis, DifferentialFemaleHumansIndiaMaleMelioidosisMiddle AgedRetrospective StudiesTuberculosis, Pulmonary

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18812053

Citation

Vidyalakshmi, K, et al. "Tuberculosis Mimicked By Melioidosis." The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease, vol. 12, no. 10, 2008, pp. 1209-15.
Vidyalakshmi K, Chakrapani M, Shrikala B, et al. Tuberculosis mimicked by melioidosis. Int J Tuberc Lung Dis. 2008;12(10):1209-15.
Vidyalakshmi, K., Chakrapani, M., Shrikala, B., Damodar, S., Lipika, S., & Vishal, S. (2008). Tuberculosis mimicked by melioidosis. The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease, 12(10), 1209-15.
Vidyalakshmi K, et al. Tuberculosis Mimicked By Melioidosis. Int J Tuberc Lung Dis. 2008;12(10):1209-15. PubMed PMID: 18812053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tuberculosis mimicked by melioidosis. AU - Vidyalakshmi,K, AU - Chakrapani,M, AU - Shrikala,B, AU - Damodar,S, AU - Lipika,S, AU - Vishal,S, PY - 2008/9/25/pubmed PY - 2009/1/9/medline PY - 2008/9/25/entrez SP - 1209 EP - 15 JF - The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease JO - Int J Tuberc Lung Dis VL - 12 IS - 10 N2 - BACKGROUND: In regions endemic for tuberculosis (TB) such as India, presumptive anti-tuberculosis treatment is often prescribed. Melioidosis, caused by Burkholderia pseudomallei, is underdiagnosed in India, due to lack of awareness and a low index of suspicion. SETTING: A tertiary care hospital in south India. OBJECTIVE: To present our analysis of a series of 22 cases of suspected TB that was later confirmed as melioidosis. DESIGN: Twenty-two patients with culture-proven melioidosis, who were initially given empirical anti-tuberculosis treatment, were retrospectively analysed regarding clinical presentation, laboratory findings and epidemiological features, with a view to determining any significant discriminatory parameter/s that would help distinguish the two diseases. RESULTS: Eight cases mimicked pulmonary TB, five tubercular arthritis, three tubercular spondylitis, two tubercular lymphadenitis, two splenic abscess, and one each mimicked tubercular pericarditis and parotid abscess. Fever was the chief presenting complaint; all had high erythrocyte sedimentation rate (ESR) values (mean 111 mm +/- 23.7 SD); 15 (68.2%) had neutrophilic leuco-cytosis, 20 (90.9%) had diabetes mellitus. Subsequent to laboratory culture reports confirming melioidosis, appropriate treatment was instituted. CONCLUSION: Fever in a diabetic patient with high ESR and neutrophilic leucocytosis should raise suspicion of melioidosis while instituting presumptive anti-tuberculosis treatment in areas where both diseases are prevalent. SN - 1027-3719 UR - https://www.unboundmedicine.com/medline/citation/18812053/Tuberculosis_mimicked_by_melioidosis_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=1027-3719&volume=12&issue=10&spage=1209&aulast=Vidyalakshmi DB - PRIME DP - Unbound Medicine ER -