Abdominal computed tomography showed a splenic abscess, and
a splenectomy was performed. Histopathology showed granulomatous inflammation, with caseous-like necrosis, consistent with
melioidosis (Fig.1). Melioidosis, caused by the Gram-negative bacilli
B pseudomallei, is an important cause of septicemia in southeast
Asia, including China, Taiwan and northern Australia. This chronic
persistent infection has a high mortality rate.B pseudomalleiis an
environmental saprophyte found in wet soils. It mostly infects
adults with an underlying predisposing background, mainly, as in
this patient, diabetes mellitus. Melioidosis is histopathologically
characterized by suppurative granulomas in the lungs, liver and
spleen. The diagnosis relies on culture, as in our case. Even after
extensive antibiotic therapy, the disease may relapse.
Further reading