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 CASE REPORT
Year : 2018  |  Volume : 66  |  Issue : 4  |  Page : 1100--1105

Melioidosis mimicking tuberculous vertebral osteitis: Case report and review of literature


1 Department of Neurosurgery, Institute of Neurosciences, Apollo Hospitals, Chennai, Tamil Nadu, India
2 Department of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, India
3 Department of Radiology, Apollo Hospitals, Chennai, Tamil Nadu, India
4 Department of Microbiology, Apollo Hospitals, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Anil Pande
Department of Neurosurgery, Institute of Neurosciences, Apollo Hospitals, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.236976

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Whitmore's disease or melioidosis is an infectious disease caused by Burkholderia pseudomallei. The reported cases are but the tip of the iceberg. This pathogenic saprophyte is commonly found in wet soil and water. An accidental or occupational exposure (in field workers, farmers, gardeners or villagers) to B. pseudomallei contaminated soil or pooled water is the primary source of infection. Neurosurgeons need to consider this as a possible rare cause of back pain and possible neurological deterioration. A diabetic type 2 rice farmer with severe lumbago and fever, misdiagnosed as vertebral tuberculous osteitis based on his radiological findings, was confirmed to harbour Burkholderia Pseudomallei, which was diagnosed using laboratory cultures. He made a remarkable recovery with antibiotic therapy. The empiric anti-tuberculous (ATT) drugs were stopped. The rare differential diagnosis of melioidosis should be thought of in diabetic patients with a psoas abscess and vertebral osteitis, especially in rice farmers from endemic regions that includes India.






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