Volume 89, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Melioidosis is an important cause of morbidity and mortality in northern Australia and Southeast Asia. Diagnosis is best made by isolation of from clinical specimens. A variety of clinical presentations are described, including neurologic disease. The aim of this study was to review admissions with confirmed neurologic melioidosis to a regional hospital in a region to which melioidosis is endemic during 1995–2011. There were 12 culture-confirmed cases of neurologic melioidosis, of which two were detected by analysis of cerebrospinal fluid. Four of these cases were in children. Significant clinical features were fever, headache, and ataxia. Common changes on magnetic resonance imaging T2-weighted scans included ring-enhancing lesions and leptomeningeal enhancement. There were four deaths and an additional four patients had significant long-term neurologic sequelae. When considering the etiology of undifferentiated neurologic disease, an awareness of the possibility of neurologic melioidosis is important in disease-endemic regions.


Article metrics loading...

Loading full text...

Full text loading...



  1. Guard RW, Khafagi FA, Brigden MC, Ashdown LR, , 1984. Melioidosis in far north Queensland. A clinical and epidemiological review of twenty cases. Am J Trop Med Hyg 33: 467.
  2. Dance D, , 1991. Melioidosis: the tip of the iceberg? Clin Microbiol Rev 4: 5260.[Crossref]
  3. Dance DA, , 2000. Melioidosis as an emerging global problem. Acta Trop 74: 115119.[Crossref]
  4. Brett PJ, Woods DE, , 2000. Pathogenesis of and immunity to melioidosis. Acta Trop 74: 201210.[Crossref]
  5. Chadwick D, Ang B, Sitoh Y, Lee C, , 2002. Cerebral melioidosis in Singapore: a review of five cases. Trans R Soc Trop Med Hyg 96: 7276.[Crossref]
  6. Suputtamongkol Y, Chaowagul W, Chetchotisakd P, Lertpatanasuwun N, Intaranongpai S, Ruchutrakool T, Budhsarawong D, Mootsikapun P, Wuthiekanun V, Teerawatasook N, , 1999. Risk factors for melioidosis and bacteremic melioidosis. Clin Infect Dis 29: 408413.[Crossref]
  7. Rajkovic I, Williams R, , 2005. Abnormalities of neutrophil phagocytosis, intracellular killing and metabolic activity in alcoholic cirrhosis and hepatitis. Hepatology 6: 252262.[Crossref]
  8. Matzner Y, Goldfarb A, Abrahamov A, Drexler R, Friedberg A, Rachmilewitz EA, , 2008. Impaired neutrophil chemotaxis in patients with thalassaemia major. Br J Haematol 85: 153158.[Crossref]
  9. Gallacher S, Thomson G, Fraser W, Fisher B, Gemmell C, MacCuish A, , 2009. Neutrophil bactericidal function in diabetes mellitus: evidence for association with blood glucose control. Diabet Med 12: 916920.[Crossref]
  10. Hirabayashi Y, Kobayashi T, Nishikawa A, Okazaki H, Aoki T, Takaya J, Kobayashi Y, , 1988. Oxidative metabolism and phagocytosis of polymorphonuclear leukocytes in patients with chronic renal failure. Nephron 49: 305312.[Crossref]
  11. Currie BJ, Fisher DA, Howard DM, Burrow JNC, , 2000. Neurological melioidosis. Acta Trop 74: 145151.[Crossref]
  12. Kumar GS, Raj PM, Chacko G, Lalitha MK, Chacko AG, Rajshekhar V, , 2008. Cranial melioidosis presenting as a mass lesion or osteomyelitis. J Neurosurg 108: 243247.[Crossref]
  13. Kalita J, Misra U, , 2000. Comparison of CT scan and MRI findings in the diagnosis of Japanese encephalitis. J Neurol Sci 174: 38.[Crossref]
  14. Woods ML, Currie BJ, Howard DM, Tierney A, Watson A, Anstey NM, Philpott J, Asche V, Withnall K, , 1992. Neurological melioidosis: seven cases from the Northern Territory of Australia. Clin Infect Dis 15: 163.[Crossref]
  15. Koszyca B, Currie B, Blumbergs PC, , 2004. The neuropathology of melioidosis: two cases and a review of the literature. Clin Neuropathol 23: 195203.
  16. Cheng AC, O'Brien M, Freeman K, Lum G, Currie BJ, , 2006. Indirect hemagglutination assay in patients with melioidosis in northern Australia. Am J Trop Med Hyg 74: 330334.
  17. Kandasamy Y, Norton R, , 2008. Paediatric melioidosis in north Queensland, Australia. J Paediatr Child Health 44: 706708.[Crossref]

Data & Media loading...

  • Received : 11 Sep 2012
  • Accepted : 08 May 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error