2026-10-14T03:24:23Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34005442 2026-09-27T18:09:50Z category_146 category_7 category_8 category_873 category_734 category_132 category_134 portal_87 item_type_3 month_year_09_2026

Disseminated melioidosis presenting as pre-septal cellulitis and multifocal abscesses in an adolescent with type 1 diabetes mellitus: a case report Nikhil John (25116322) Pediredla Karunakar (25116325) Rajashree Choudhury (25116328) Arun Babu T (25116331) Sumit Rai (15143805) Debabrata Dash (616301) Space Science Medicine Microbiology Chemical Sciences not elsewhere classified Biological Sciences not elsewhere classified Infectious Diseases Virology Melioidosis Burkholderia pseudomallei type 1 diabetes mellitus preseptal cellulitis splenic abscess MALDI-ToF multifocal abscess case report Melioidosis, caused by Burkholderia pseudomallei, produces a wide range of clinical manifestations and may be difficult to diagnose in the pediatric population. We describe the case of a 12-year-old girl with poorly controlled type 1 diabetes mellitus that posed diagnostic challenges. Over 4 months, she experienced relapsing fever, multiple splenic abscesses with a ‘target sign’ on ultrasonography, right-sided preseptal cellulitis, and a left thigh ulcer. Repeated cultures of superficial swabs and blood yielded no growth of bacteria. Radiological mimicry and culture-negative results raised concerns regarding a fungal etiology, leading to empiric amphotericin B therapy. The definitive diagnosis was made after incision and drainage of a 4 × 6 cm2 frontal abscess. Pus culture isolated Burkholderia pseudomallei, identified by matrix‑assisted laser desorption/ionization time‑of‑flight mass spectrometry (MALDI‑ToF MS). Patient was treated with intravenous meropenem for 4 weeks followed by oral cotrimoxazole for a planned 3‑month eradication course. The patient recovered with no relapse on follow‑up. This case highlights the need to consider melioidosis in diabetic patients presenting with recurrent, culture-negative abscesses that display a target sign in endemic regions. Deep tissue culture remains essential for diagnosis, as superficial swabs may be misleading. Source control, coupled with dual-phase antimicrobial therapy, remain the cornerstones of effective management 2026-09-27T18:09:50Z Dataset Dataset 10.6084/m9.figshare.34005442.v1 https://figshare.com/articles/dataset/Disseminated_melioidosis_presenting_as_pre-septal_cellulitis_and_multifocal_abscesses_in_an_adolescent_with_type_1_diabetes_mellitus_a_case_report/34005442 CC BY 4.0