Abstract:
Background: Melioidosis is a potentially fatal bacterial infection caused by Burkholderia pseudomallei. The existence
of melioidosis in Sri Lanka was once unheard of, and entertaining it as a diagnosis in clinical practice was extremely
rare.
Case presentation: In this case report, we describe the clinical, epidemiological, and longitudinal follow-up data of
a 58-year-old previously healthy Sinhalese woman who presented to our hospital with protracted febrile illness of 5
weeks’ duration, later developing multiple abscesses at different sites of the body. There was a significant delay in
confirming the diagnosis of melioidosis by isolating B. pseudomallei from blood and pus cultures. The patient
recovered fully with a prolonged course of antibiotics and has remained in good health over the last 13 years
without recurrence. Despite being immunocompetent, she had contracted the infection by a brief contact with
mud soil in a footpath.
Conclusions: A high index of clinical suspicion along with laboratory support is needed to confirm the diagnosis of
melioidosis. Treatment with sensitive antibiotics over a long duration is needed, and longitudinal follow-up is
essential to detect recurrences. This case raised awareness and created renewed interest in studies of melioidosis in
Sri Lanka.
Keywords: Burkholderia pseudomallei, Melioidosis, Sri Lanka
