Melioidosis - Skin Infection 63M h/o diabetes with c/o fever, chest pain, dyspnea x 3 days, CT chest - left lower lobe pneumonia with left pleural effusion. + skin lesions on chest (pic attached with progressive changes), Develops respiratory failure -> intubated. Blood/wound cultures ->gram-negative rods. Diagnosis: Melioidosis - Gram-negative bacterium Burkholderia pseudomallei. First recognised in 1911, found in the rhizosphere (the layer of soil directly influenced by root secretions and soil microorganisms) and surface groundwater. Exposure through broken skin, inhalation or ingestion. Risk factors -> diabetes (12x higher risk), exposure to soil or unchlorinated water, age >45 yrs, alcoholism, liver/lung/kidney disease, thalassaemia (?neutrophil dysfunction 2/2 iron overload), immunosuppression. #Melioidosis #Skin #Infection #Cellulitis #Clinical #Photo #dermatology
