Meliodosis in Cirrhosis of Liver- A Case Series. Gastroenterol Hepatol Int J 2016, 1(2): 000112

The first patient presented with high grade fever, vomiting and right upper quadrant abdominal pain for 2 weeks. He had undergone drainage of splenic abscess elsewhere. Computed tomography revealed hypodense, cavitatory lesions with honeycomb pattern in liver and spleen suggestive of multiple abscesses (Figure 1). The liver abscess was drained. After an initial response to intravenous meropenem, he developed pain and swelling over the left knee joint. Synovial fluid aspiration showed 3500 cells with predominant neutrophils. Moreover, he developed simple focal seizures involving the right upper limb. CT brain showed multiple brain abscesses probably due to septic embolization. Despite aggressive supportive care and adequate antibiotic therapy treatment, he succumbed to disseminated meliodosis involving liver, spleen, brain, joints and lungs. Figure 1: A representative computed tomography of Case 1.