1.Non-bacteremia liver abscess caused by Burkholderia pseudomallei from a tertiary teaching hospital in Malaysia: a case report and literature review
Wahab, A.A. ; Nurazizah, S.M.A. ; Ding, C.H. ; Muttaqillah, N.A.S. ; Nordashima, A.S. ; Kori, N. ; Periyasamy, P.
Tropical Biomedicine 2023;40(No.3):290-294
Melioidosis is endemic in Southeast Asia, including Malaysia. Liver abscess is not uncommon in
melioidosis, but it is usually associated with bacteremia. We presented a case of a 55-year-old gentleman
with underlying end-stage renal failure who presented with non-specific abdominal pain for three
months. Initial blood investigations showed leukocytosis and increased C-reactive protein. Computed
tomography (CT) of the abdomen revealed multiple hypodense lesions in the liver and spleen. The culture
of the liver specimen obtained through the ultrasound-guided isolated Burkholderia pseudomallei. He
was given an adjusted dose of intravenous ceftazidime due to underlying renal failure. Melioidosis
serology also returned positive for IgM with titer >1:1280. His blood cultures were reported negative
three times. Despite on antibiotics for five weeks, there was no significant improvement of the liver
abscesses was observed. He was unfortunately infected with the SARS-CoV-2 virus during his admission
and passed away due to severe COVID-19 pneumonia.