Melioidosis: A Review and Update for the Special Operations Provider.

Severe Disseminated Melioidosis with Pulmonary, Cutaneous, and Osteoarticular Involvement in the Peruvian Amazon.

Melioidosis is a potentially fatal tropical infection caused by Burkholderia pseudomallei. Although well described in Southeast Asia and northern Australia, its burden in South America remains poorly characterized and likely underestimated. A case of severe disseminated melioidosis in a 35-year-old man with poorly controlled diabetes mellitus residing in the Peruvian Amazon is reported here. The patient presented multifocal pneumonia, bacteremia, and septic shock requiring mechanical ventilation and vasopressor support. During hospitalization, he developed cutaneous microabscesses and septic arthritis of the left knee. Burkholderia pseudomallei was isolated from both blood cultures and synovial fluid, confirming hematogenous dissemination. This case highlights the presence of severe melioidosis in the Peruvian Amazon and underscores the need to consider this pathogen in patients presenting with severe sepsis in tropical regions with high environmental exposure and metabolic risk factors. Strengthening microbiological diagnostic capacity is essential to improve detection of this emerging infection in South America.

Disseminated melioidosis with multiple visceral abscesses including prostatic abscess

Melioidosis, caused by Burkholderia pseudomallei, is an emerging tropical infectious disease. We report a 61-year-old male farmer from Itaiçaba, Ceará, Brazil, with type 2 diabetes mellitus, who presented with prolonged fever, abdominal pain, and weight loss. Imaging showed a multiloculated hepatic abscess, followed by splenic and prostatic abscesses, without pulmonary involvement. Blood and urine cultures isolated B. pseudomallei. The patient received intravenous meropenem followed by oral trimethoprim-sulfamethoxazole for six months, with a favourable outcome. This case highlights an atypical disseminated presentation and reinforces clinical suspicion of melioidosis in diabetic patients with visceral abscesses in endemic regions. 

Rare manifestation of melioidosis with suppurative pericarditis: A case report and mini review

Melioidosis is a serious infectious disease caused by Burkholderia pseudomallei, a bacterium endemic to tropical regions, including Taiwan. The disease can involve multiple organs; however, cardiac involvement, particularly cardiac tamponade, is rare. To date, only four cases of melioidosis presenting with cardiac tamponade have been reported in the literature. Here, we report an extremely rare case of melioidosis complicated by pericardial effusion and cardiac tamponade, which was successfully treated with pericardiocentesis and appropriate antimicrobial therapy.

Melioidosis in Mexico: Description of the Disease, Review of Human Cases, and Public Health Impact

Atypical pulmonary manifestation of brucellosis in a non-endemic region: case report from Slovakia

Brucellosis is a zoonotic infection with diverse clinical manifestations. Pulmonary involvement is rare—occurring in less than 1% of cases—and typically limited to endemic regions. In Slovakia, where brucellosis is non-endemic, human cases are exceptional. We present a rare and severe respiratory form of brucellosis in a patient with occupational exposure to livestock. We describe a 40-year-old female dairy farm worker admitted with fever, chills, and dyspnea. Initial workup revealed mild laboratory abnormalities and chest infiltrates. Despite empirical antibiotics, her condition rapidly progressed to acute respiratory distress syndrome (ARDS), acute kidney injury, and septic shock. Mechanical ventilation and vasopressor support were required. Serological testing confirmed Brucella abortus infection. Antibiotic therapy was escalated to tigecycline and meropenem, with subsequent clinical improvement. Follow-up imaging showed significant regression of pulmonary infiltrates. The patient completed a six-week course of doxycycline and fully recovered. This case underlines the importance of considering brucellosis in febrile patients with livestock exposure, even in non-endemic settings. Severe pulmonary forms are rare but life-threatening. Early recognition, targeted antibiotic therapy, and multidisciplinary care are critical for favorable outcomes. Pulmonary brucellosis is rare (< 1% of cases) but can be life-threatening, even in non-endemic regions. Occupational exposure to livestock is the primary risk factor in non-endemic settings such as Slovakia. Tigecycline is a viable alternative in complicated brucellosis with renal failure due to its non-renal elimination. Multidisciplinary care and dynamic serological monitoring were crucial for successful patient management.

Pediatric melioidosis: a scoping review of epidemiology, clinical presentation, management, and outcomes.

BACKGROUND Pediatric melioidosis is an under-recognised but potentially severe infection caused by Burkholderia pseudomallei. Evidence is largely fragmented across case reports and small series, limiting understanding of disease patterns, severity, and outcomes in children. METHODS A scoping review was conducted in accordance with PRISMA-ScR 2020 guidelines. PubMed and Google Scholar were searched up to December 2025 for studies reporting culture-confirmed melioidosis in children (≤18 years). Case reports, case series, and observational studies were included. Given the heterogeneity of available data, findings were synthesised narratively with emphasis on clinical patterns and outcome determinants. RESULTS A total of 140 studies comprising 1,058 pediatric cases were included. Most cases were reported after 2000 and originated from Southeast Asia and northern Australia. Pediatric melioidosis demonstrated a broad clinical spectrum, ranging from localized infections (predominantly parotid, lymphatic, and skin involvement) to severe disseminated disease with bacteraemia and pneumonia. Overall mortality was 22.4% (229/1024). Mortality was markedly lower in localized melioidosis (0.7%; 4/557) than in disseminated disease (46.2%; 226/489) and was highest in neonatal (56.0%) and neurologic melioidosis (51.7%). Diagnostic delay ranged from 1 to 420 days and was frequently associated with severe and fatal outcomes, suggesting progression from initially localized infection to disseminated disease. CONCLUSIONS Pediatric melioidosis follows a phenotype-severity continuum, with outcomes strongly influenced by disease pattern and timeliness of diagnosis. Early recognition of localized disease and prompt microbiological confirmation are critical to preventing progression and reducing mortality. This review provides a consolidated framework for understanding pediatric melioidosis and highlights key priorities for clinical practice and future research.