Melioidosis: A 5-year Review from a Single Institution in Pondicherry.

ABSTRACT

INTRODUCTION: Forty-four percent of global cases are predicted to occur in the Indian sub-continent, but less than 2000 cases have been reported. Though the number of predicted cases in India is reported to be high, lesser numbers are being reported due to a lack of diagnostic capabilities and poor awareness of the disease. AIMS: We aimed to estimate the number of cases of melioidosis over a 5-year period, the proportion of non-survivors, and map the geographical regions of the patients. METHODS: Retrospectively, medical case records were reviewed with the search terms melioidosis and Burkholderia pseudomallei. Data on the geographical region, risk factors, clinical manifestations, and outcomes were collected and analysed. RESULTS: Thirty-four patients with melioidosis were found. 12/34 had died in the hospital. Case records of only 20 patients (M=19, F=1) could be traced. Patients who died were older and had a longer duration of symptoms, had higher total leukocyte counts, higher platelet counts, and more severe hepatic and renal dysfunction compared to those who survived. Being a teetotaller, having received intensive care, and mechanical ventilation showed statistical significance between the two groups. CONCLUSION: Three centres from Pondicherry have reported melioidosis; this study had the most significant reported number of cases from a single institution in Pondicherry. The mapping of our patients resulted in probable evidence of melioidosis in six other districts of Tamil Nadu. Since the Indian population is at high risk because of diabetes, and melioidosis can mimic tuberculosis, increased awareness among physicians is a must to diagnose and treat this disease with high mortality.