Raja N S.
Localized Melioidosis.
J Pak Med Assoc Jan ;53(8):373-4.

An obese boy (aged 11 years) was referred from Klang General Hospital as a case of non-healing ulcer (measuring 4x2 cm) over the right inguinal region. He had been admitted there for 2 weeks for the management of the ulcer that had resulted from the collection of pus. He was diagnosed as type 2 Diabetes mellitus. He also had a history of multiple abscesses over the buttocks for one and half years but that resolved without any medication. Blood chemistry showed the following results: Sugar level 378 mg/dl, total cholesterol 222 mg/dl, white blood cells 12.8, and ESR 22 mm/hour. Pus swab from the ulcer gave rise to Burkholderia pseudomallei that was sensitive to Cotrimoxazole, Augmentin, Ceftazidime, Cefoperazone, Ciprofloxacin, chloramphenicol, and imipenem while resistant to aminoglycosides. Burkholderia pseudomallei were isolated by conventional methods and API 20 NE [manufactured by Bio Merioux France], on the other hand sensitivity was done by disc diffusion method. Melioidosis serology showed result 1:80 was diagnostic. His total glycosylated hemoglobin was high. After initiation of Ceftazidime and Augmentin and control of sugar level by insulin, the ulcer started healing. He was referred back to Klang General Hospital for follow up.

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