ReviewInfectious disease reports2026
Atypical Presentations in Melioidosis: A Case-Based Review from Endemic Regions.
Review in Infectious disease reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMelioidosis, caused by
objectiveThe objective is to improve diagnostic accuracy and increase clinical awareness in both endemic and non-endemic settings by reviewing and classifying atypical presentations of melioidosis that have been documented in the literature.
methodsA narrative, case-based review was conducted using 238 published case reports and series from endemic and transitional regions during the period from 2000 to 2025. Cases with non-respiratory presentations or anatomical locations not commonly linked to melioidosis were classified as atypical. Clinical syndromes were used to classify the extracted cases, and common patterns in presentation, diagnosis, and outcome were examined.
resultsOne hundred and sixty published articles were included after a full text review. The most frequent atypical presentations included neurological involvement (e.g., brain abscess, encephalomyelitis), musculoskeletal infections (osteomyelitis, myositis), thyroid abscess, tubo-ovarian abscess, and dermatologic manifestations such as erythema nodosum. Imported and pediatric cases were also found. Numerous cases were misidentified as cancer, fungal infections, or tuberculosis. Among risk factors, diabetes mellitus was the most prevalent. Non-specific symptoms, a lack of laboratory capacity, and incorrect pathogen identification frequently resulted in delays in diagnosis.
conclusionsIn endemic areas, melioidosis should be taken into account when making a differential diagnosis of a variety of clinical syndromes, especially in patients who have diabetes or have had relevant environmental exposure. Poor outcomes and diagnostic delays are greatly exacerbated by atypical presentations. Improving diagnostic capabilities and raising awareness are crucial to lessening the worldwide burden of this often ignored but potentially deadly infection.
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