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|Benson Yeo, Joyce Lee and Jiun-Yit Pan|
|National Skin Centre, Singapore|
|Posters & Accepted Abstracts: J Clin Exp Dermatol Res|
|Melioidosis is an endemic infection in Southeast Asia and Northern Australia caused by the Gram-negative bacteria Burkholderia pseudomallei. Systemic melioidosis usually occurs in immunocompromised patients such as those with diabetes mellitus or chronic renal failure. However, cutaneous melioidosis are more often seen in young otherwise healthy patients. We report a case of cutaneous melioidosis in a 28 year old Chinese man with a history of soil exposure during a military exercise. He presented with a non-healing 5.7×3.7 cm ulcerated discharging plaque on his left knee of 1 year duration. A skin tissue culture on blood agar plate grew Burkholderia pseudomallei. However, instead of the typical chronic granulomatous inflammation seen in melioidosis, our patient’s skin biopsy showed a predominant plasma cell superficial and deep perivascular infiltrate. The ulcer continued to worsen despite a trial of oral amoxicillin-clavulanic acid for 6 weeks. Our patient was subsequently given 2 weeks of intravenous ceftrazidime followed by 3 months of oral cotrimoxazole with eventual resolution of the ulcerated plaque. The lack of granulomatous inflammation may be a cause of the failure of oral antibiotics.|
Benson Yeo has obtained his Medical degree from the Yong Loo Lin School of Medicine, National University of Singapore in 2008. He has obtained his Specialist accreditation in Dermatology in 2016 in Singapore and is currently an Associate Consultant Dermatologist at the National Skin Centre, Singapore.
Email: [email protected]
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