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BMJ Case Rep ; 14(2)2021 Feb 04.
Article in English | MEDLINE | ID: mdl-33541991

ABSTRACT

Diabetes mellitus, type 1 in particular, is a well-recognised risk factor for melioidosis, a disease caused by Burkholderia pseudomallei Melioidosis is endemic in Southeast Asia and in northern Australia and has a variety of clinical presentation, isolated splenic abscess being one of them. B. pseudomallei, however, is an uncommon aetiology of splenic abscess. The diagnosis of melioidosis is often overlooked unless the clinician and the microbiologist are suspicious of the condition. Multiple splenic abscesses and perisplenic collection were noted in CT scan of the abdomen in a patient of type 1 diabetes, presenting with fever for preceding 4 weeks. B. pseudomallei was isolated from the splenic aspirate and the diagnosis was made based on gram stain and routine biochemical tests. He was successfully treated with antibiotics. We postulate that the likely route of infection was inoculation through skin, the integrity of which was compromised by multiple subcutaneous insulin injections.


Subject(s)
Abdominal Abscess/complications , Burkholderia pseudomallei/isolation & purification , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Melioidosis , Splenic Diseases/complications , Abdominal Pain/etiology , Adolescent , Diabetes Mellitus, Type 1/complications , Fever/etiology , Humans , Male , Melioidosis/complications , Melioidosis/diagnosis , Tomography, X-Ray Computed
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