Clinical Spectrum of Melioidosis in Diabetic Patients: A Case Series from a Tertiary Care Center in India

Abstract

Background: Melioidosis, caused by Burkholderia pseudomallei, is an emerging infectious disease in Southeast Asia and the Indian subcontinent. Diabetes mellitus is the most significant predisposing factor. The disease presents a diagnostic challenge due to its wide clinical spectrum and mimicry of other common infections. Case Summary: We describe three cases of culture-confirmed Melioidosis in male patients with diabetes mellitus, each presenting with different manifestations — chronic soft tissue abscess, disseminated visceral abscesses with vascular complications, and rapidly progressive cellulitis. All cases required surgical or radiological intervention, prolonged intravenous antibiotic therapy, and a structured eradication phase with oral antibiotics. Each patient responded favourably to treatment with no early recurrence. Conclusion: This case series underscores the protean nature of Melioidosis in diabetic patients. A high index of suspicion, timely diagnosis through microbiological culture, and adherence to the two-phase treatment protocol are critical for favourable outcomes.