Melioidosis and tuberculosis: Dual pathogens in a neck abscess

Introduction: Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, abscesses in soft tissue and various organs, or as septicaemia.Case report: We report a case of a 40-year-old, diabetic man who presented with a neck lump resulting from super-infection of a tuberculosis cavity with B pseudomallei. The patient was successfully managed by drainage along with meticulous excision of the capsule and prolonged antibiotic and anti-tubercular treatment.Discussion: Melioidosis may be confused diagnostically with tuberculosis, as both diseases are endemic in the same regions. Our patient was unfortunate to suffer from both endemic diseases simultaneously, perhaps representing the first such case in the world literature.Conclusion: Increased awareness of melioidosis is important as, although the organism is easy to culture, it may be dismissed as a contaminant.