Melioidosis in kidney transplant recipients: A report of two cases.

Rationale: Melioidosis is a serious opportunistic infection caused by Patient concerns: Case 1 was a 34-year-old male kidney transplant recipient who presented with a 15-day history of intermittent fever, accompanied by liver and spleen abscesses. Case 2 was a 37-year-old female kidney transplant recipient who presented with acute febrile illness and developed leucopenia. Blood cultures for both patients grew Diagnosis: Both patients were diagnosed with melioidosis caused by Interventions: Both patients were treated with an intensive regimen of meropenem (renal-adjusted doses), followed by a 3-month course of oral cotrimoxazole for eradication therapy. Outcomes: Case 1 experienced resolution of liver and spleen abscesses after 3 months of treatment and continued to recover well. In Case 2, blood cultures became sterile after 4 weeks, with no further complications observed. Lessons: Melioidosis should be suspected in immunocompromised patients, especially kidney transplant recipients, who present with unexplained fever and sepsis-like symptoms. Early diagnosis through aspiration of abscesses and prompt treatment are critical for preventing relapses and improving patient outcomes.