A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation

In Malaysia, melioidosis is not a notifiable disease but has a high mortality rate, particularly in diabetic patients. Disseminated melioidosis can be fatal, with 16% to 37% of cases presenting with nonspecific symptoms, complicating early diagnosis. Some patients develop abscesses with or without b...

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Main Authors: Zakariah, Siti Zulaikha, Mohd Kamaruzzaman, Nur Hannah, Abdul Aziz, Nurul Izzati, Ibrahim, Rosni, Damanyanti, Rinni, Kandasamy, Thenmalar
Format: Article
Language:English
Published: UPM 2024
Online Access:http://psasir.upm.edu.my/id/eprint/117926/
http://psasir.upm.edu.my/id/eprint/117926/1/117926.pdf
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author Zakariah, Siti Zulaikha
Mohd Kamaruzzaman, Nur Hannah
Abdul Aziz, Nurul Izzati
Ibrahim, Rosni
Damanyanti, Rinni
Kandasamy, Thenmalar
author_facet Zakariah, Siti Zulaikha
Mohd Kamaruzzaman, Nur Hannah
Abdul Aziz, Nurul Izzati
Ibrahim, Rosni
Damanyanti, Rinni
Kandasamy, Thenmalar
author_sort Zakariah, Siti Zulaikha
building UPM Institutional Repository
collection Online Access
description In Malaysia, melioidosis is not a notifiable disease but has a high mortality rate, particularly in diabetic patients. Disseminated melioidosis can be fatal, with 16% to 37% of cases presenting with nonspecific symptoms, complicating early diagnosis. Some patients develop abscesses with or without bacteremia. We present a fatal case of disseminated melioidosis in a diabetic patient with vague initial symptoms. Remarkably, she exhibited low septic parameters, including a normal white blood cell count and low C-reactive protein levels, which masked the severity of the infection and delayed appropriate treatment. The absence of early radiological findings and specific laboratory tests further complicated the diagnostic process. This case underscores the necessity for heightened clinical awareness and the advancement of diagnostic tools, particularly in high-risk populations, to facilitate timely interventions and mitigate fatal outcomes.
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spelling upm-1179262025-06-17T02:47:05Z http://psasir.upm.edu.my/id/eprint/117926/ A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation Zakariah, Siti Zulaikha Mohd Kamaruzzaman, Nur Hannah Abdul Aziz, Nurul Izzati Ibrahim, Rosni Damanyanti, Rinni Kandasamy, Thenmalar In Malaysia, melioidosis is not a notifiable disease but has a high mortality rate, particularly in diabetic patients. Disseminated melioidosis can be fatal, with 16% to 37% of cases presenting with nonspecific symptoms, complicating early diagnosis. Some patients develop abscesses with or without bacteremia. We present a fatal case of disseminated melioidosis in a diabetic patient with vague initial symptoms. Remarkably, she exhibited low septic parameters, including a normal white blood cell count and low C-reactive protein levels, which masked the severity of the infection and delayed appropriate treatment. The absence of early radiological findings and specific laboratory tests further complicated the diagnostic process. This case underscores the necessity for heightened clinical awareness and the advancement of diagnostic tools, particularly in high-risk populations, to facilitate timely interventions and mitigate fatal outcomes. UPM 2024 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/117926/1/117926.pdf Zakariah, Siti Zulaikha and Mohd Kamaruzzaman, Nur Hannah and Abdul Aziz, Nurul Izzati and Ibrahim, Rosni and Damanyanti, Rinni and Kandasamy, Thenmalar (2024) A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation. Malaysian Journal of Medicine and Health Sciences, 20 (suppl.11). pp. 120-122. ISSN 1675-8544 https://medic.upm.edu.my/upload/dokumen/2024123018381025_MJMHS_0435.pdf 10.47836/mjmhs20.s11.25
spellingShingle Zakariah, Siti Zulaikha
Mohd Kamaruzzaman, Nur Hannah
Abdul Aziz, Nurul Izzati
Ibrahim, Rosni
Damanyanti, Rinni
Kandasamy, Thenmalar
A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
title A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
title_full A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
title_fullStr A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
title_full_unstemmed A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
title_short A fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
title_sort fatal case of disseminated melioidosis in a diabetic patient: diagnostic challenges and atypical presentation
url http://psasir.upm.edu.my/id/eprint/117926/
http://psasir.upm.edu.my/id/eprint/117926/
http://psasir.upm.edu.my/id/eprint/117926/
http://psasir.upm.edu.my/id/eprint/117926/1/117926.pdf