Primary cutaneous melioidosis - A rare case needing intensive care unit admission

Background: Melioidosis cases are increasing in Southeast Asia, posing a significant challenge owing to the rising number of diabetic and immune compromised patients. Pneumonia is the most common presentation of melioidosis, while cutaneous melioidosis is rare.

Objectives: We report a case of primary cutaneous melioidosis (PCM) that eventually required intensive care unit (ICU) management.

Methods: We describe the case of a 33-year-old male with uncontrolled diabetes mellitus who initially presented with a skin lesion, which was followed by gradual multiorgan involvement diagnosed as melioidosis based on culture-positive results from blood and synovial fluid, and needed ICU admission.

Results: He was successfully treated with intravenous antibiotics and invasive mechanical ventilation after ICU admission.

Conclusion: Cutaneous melioidosis can lead to ICU admission and, if untreated, has a high fatality rate. Faster diagnostic methods like VITEK 2 Compact and MALDI TOF substantially reduce delays in initiating required treatment.

Contribution of the study: Our study emphasize on the need of considering Meliodosis as a possible differential diagnosis, as in lower middle income countries (LMIC) where it can be a frequent cause of multiorgan involvement due to tropical environment and diagnostic resource limitations.