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Melioidosis — SCE Infectious Diseases MCQ

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HardTropical & Imported InfectionsMelioidosisSCE Infectious Diseases

A 48-year-old man with no travel history develops a febrile illness with severe right-sided chest pain. He is a keen gardener. Blood cultures grow Burkholderia pseudomallei. CT chest shows a cavitating right upper lobe lesion. He has poorly controlled type 2 diabetes. What is the diagnosis and where might he have acquired the infection?

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Correct answer: B — Melioidosis; he likely acquired it from contaminated soil or water during gardening — imported soil or plant products can harbour B. pseudomallei

Burkholderia pseudomallei causes melioidosis, endemic to South-East Asia and Northern Australia. Cases in non-endemic countries can occur through exposure to imported contaminated soil, plants, or water. Diabetes is the most important risk factor. Melioidosis can mimic TB clinically and radiologically (cavitating upper lobe pneumonia, septicaemia). Treatment requires intensive phase (IV Meropenem or Ceftazidime for ≥10–14 days) followed by eradication phase (oral Co-trimoxazole for 3–6 months). Without eradication therapy, relapse rates exceed 20%.

Reference: UKHSA 2023 – Melioidosis; WHO 2022 – Melioidosis guidelines