Krishna Mokkarala Satya Vamsi, Lakshmanan Suja, Rajendran Vaasanthi, Senthil N, Ayub Irfan Ismail
General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Pulmonary and Critical Care Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Jul 7;16(7):e64024. doi: 10.7759/cureus.64024. eCollection 2024 Jul.
A young male, plantation worker from Southeast Asia, presented with a non-productive cough, intermittent high-grade fever with chills, and significant weight loss over two months. Prior investigations were non-contributory, despite various antibiotics, his symptoms persisted. Physical examination and routine investigations, including an extensive microbiological workup for fever were non-contributory. A positron emission tomography-computed tomography (PET-CT) scan performed for pyrexia of unknown origin (PUO) revealed pulmonary consolidation, mediastinal lymphadenopathy, and splenic microabscesses. Material aspirated via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) from the left interlobar lymph node was positive for on conventional nested polymerase chain reaction (PCR), confirming a diagnosis of melioidosis. Following appropriate antibiotic therapy, there was a complete resolution of symptoms. This case underscores the diagnostic challenges and the need for advanced techniques in identifying melioidosis, which can mimic tuberculosis.
一名来自东南亚的年轻男性种植园工人，出现干咳、间歇性高热伴寒战，且在两个月内体重显著减轻。此前的检查没有提供有用线索，尽管使用了各种抗生素，他的症状仍持续存在。体格检查和常规检查，包括针对发热进行的广泛微生物学检查，均未提供有用线索。为不明原因发热（PUO）进行的正电子发射断层扫描 - 计算机断层扫描（PET - CT）显示肺部实变、纵隔淋巴结肿大和脾脏微脓肿。通过支气管内超声引导下经支气管针吸活检（EBUS - TBNA）从左叶间淋巴结吸出的材料，在传统巢式聚合酶链反应（PCR）中检测呈阳性，确诊为类鼻疽病。经过适当的抗生素治疗后，症状完全缓解。该病例强调了诊断类鼻疽病的挑战以及在识别可模仿结核病的类鼻疽病时采用先进技术的必要性。
