Advertisement

Melioidosis mimicking miliary tuberculosis

  • Ran Zhi Tan
  • Faridah Mohd Nor
  • Swarhib Shafie
  • Lii Jye Tan
Images in Forensics

Abstract

Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a gram-negative intracellular bacillus. Tuberculosis, also an infectious disease, is caused by Mycobacterium tuberculosis, an acid fast bacillus. In both diseases, patients commonly present with fever and respiratory symptoms due to sepsis which might lead to respiratory failure or sudden death if left untreated. Not only are these two entities similar in clinical presentation, but the autopsy findings may mimic each other, giving rise to difficulties in determining the cause of death. We report a case of melioidosis and compare it to a typical case of miliary tuberculosis. Similarities between the cases on gross and histopathological examinations are discussed. In such circumstances, microbiological culture of bodily fluids and internal organs should be performed to ascertain the correct cause of death.

Keywords

Melioidosis Miliary tuberculosis Burkholderia pseudomallei Forensic 

Notes

Compliance with ethical standards

Conflict of interest

All authors hereby disclose that there are no financial and personal relationships with any other people or organizations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding.

Ethical approval and informed consent

Compliance with Ethical Standards Editorial.

References

  1. 1.
    Soo CI, Wahab SA, Hamid FA. Pulmonary melioidosis presenting with pleural effusion: a case report and review of literature. Resp Med Case Rep. 2015;16:54–6.Google Scholar
  2. 2.
    Puthucheary SD. Melioidosis in Malaysia. Med J Malaya. 2009;64:266–74.PubMedGoogle Scholar
  3. 3.
    Zhi TR, Yaro SW, Nor MF, Swarhib S, Bakar SN, Wazir MR. Fatality by melioidosis. Intern Med J. 2017;24:425–6.Google Scholar
  4. 4.
    Currie BJ, Fischer DA, Howard DM, Burrow JN, Selvanayagam S, Snelling PL, et al. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop. 2000;74:121–7.CrossRefGoogle Scholar
  5. 5.
    Lopez-Acevedo MN, Santiago ZC, Cintron WR. Miliary tuberculosis still a great problem. Infect Dis Clin Pract. 2009;17:401–3.CrossRefGoogle Scholar
  6. 6.
    Wong KT, Puthucheary SD, Vadivelu J. The histopathology of human melioidosis. Histopathology. 1995;26:51–5.CrossRefGoogle Scholar
  7. 7.
    Puthucheary SD, Parasakthi N, Lee MK. Septicaemic melioidosis-a review of 50 cases from Malaysia. Trans Roy Soc Trop Med Hyg. 1992;86:683–5.CrossRefGoogle Scholar
  8. 8.
    Suputtamongkol Y, Hall AJ, Dance DAB, Chaowagul W, Rajchanuvong A, Smith MD, et al. The epidemiology of melioidosis in Ubon Ratchathani, northeast Thailand. Int J Epidemiol. 1994;23:1082–90.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ran Zhi Tan
    • 1
  • Faridah Mohd Nor
    • 1
  • Swarhib Shafie
    • 1
  • Lii Jye Tan
    • 1
  1. 1.Forensic Unit, Department of PathologyUniversiti Kebangsaan Malaysia Medical CentreKuala LumpurMalaysia

Personalised recommendations