{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T18:33:33Z","timestamp":1774290813325,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report a case of melioidosis presenting as isolated necrotic mediastinal lymphadenopathy in a 60-year-old man from coastal Karnataka with poorly controlled diabetes (HbA1c 9.9%). Such a presentation, closely mimicking tuberculosis, is rarely described in the literature. Dual microbiological confirmation through sputum culture and endobronchial ultrasound (EBUS) guided lymph node aspiration established the diagnosis of Burkholderia pseudomallei. This case underscores the importance of considering melioidosis in the differential diagnosis of necrotic mediastinal lymphadenopathy, particularly in endemic regions and in diabetic patients. Early recognition and appropriate therapy remain crucial to prevent complications and improve outcomes in this potentially fatal but treatable infection.<\/jats:p>","DOI":"10.1093\/omcr\/omag032","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:43:54Z","timestamp":1774287834000},"source":"Crossref","is-referenced-by-count":0,"title":["Whispers of decay: necrotic mediastinal lymphadenopathy due to melioidosis in a diabetic patient"],"prefix":"10.1093","volume":"2026","author":[{"given":"Rathan","family":"Kamath","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, Udupi, Karnataka 576104 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, Udupi, Karnataka 576104 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anirudh","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, Udupi, Karnataka 576104 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5106-6200","authenticated-orcid":false,"given":"Muralidhar","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, Udupi, Karnataka 576104 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen Kumar","family":"Tirlangi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, Udupi, Karnataka 576104 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"2026032313434931100_ref1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/S0035-9203(08)70002-6","article-title":"The global distribution of Burkholderia pseudomallei and melioidosis: an update","volume":"102 Suppl 1","author":"Currie","year":"2008","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2026032313434931100_ref2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/S0001-706X(99)00059-5","article-title":"Melioidosis as an emerging global problem","volume":"74","author":"Dance","year":"2000","journal-title":"Acta Trop"},{"key":"2026032313434931100_ref3","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1093\/trstmh\/trae017","article-title":"Predictors of 28-day mortality in melioidosis patients presenting to an emergency department: a retrospective cohort study from South India","volume":"118","author":"Nisarg","year":"2024","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2026032313434931100_ref4","doi-asserted-by":"crossref","first-page":"412","DOI":"10.4103\/ijmy.ijmy_148_19","article-title":"Concurrent melioidosis and tuberculosis: an expected incidence in endemic tropical country","volume":"8","author":"Sriwijitalai","year":"2019","journal-title":"Int J Mycobacteriology"},{"key":"2026032313434931100_ref5","first-page":"734","article-title":"It is tuberculosis or melioidosis? A clinical diagnostic dilemma","volume":"76","author":"Jamani","year":"2021","journal-title":"Med J Malaysia"},{"key":"2026032313434931100_ref6","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.ijtb.2023.06.014","article-title":"Are we dealing with melioidosis under the mask of tuberculosis? - a case series","volume":"71","author":"Kottarathil","year":"2024","journal-title":"Indian J Tuberc"},{"key":"2026032313434931100_ref7","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1177\/00494755221095711","article-title":"Cavitary lung disease in hospitalized patients: differences between melioidosis and tuberculosis","volume":"52","author":"Lam","year":"2022","journal-title":"Trop Dr"},{"key":"2026032313434931100_ref8","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.22.00770","article-title":"Coinfection of melioidosis and tuberculosis causing infective lumbar spondylodiscitis: a rare case report","volume":"13","author":"Jain","year":"2023","journal-title":"JBJS Case Connect"},{"key":"2026032313434931100_ref9","first-page":"1","article-title":"Pulmonary tuberculosis and melioidosis coinfection in Brunei Darussalam: the importance of awareness and screening","volume":"13","author":"Rubel","year":"2022","journal-title":"West Pac Surveill Response J WPSAR"},{"key":"2026032313434931100_ref10","doi-asserted-by":"crossref","first-page":"100458","DOI":"10.1016\/j.ijmmb.2023.100458","article-title":"Pulmonary tuberculosis and neurologic melioidosis coinfection-first case report from Madurai","volume":"46","author":"Vithiya","year":"2023","journal-title":"Indian J Med Microbiol"},{"key":"2026032313434931100_ref11","doi-asserted-by":"publisher","DOI":"10.4081\/monaldi.2020.1221","article-title":"Utility of endobronchial ultrasound guided trans-bronchial needle aspiration in diagnosis of melioidosis - case series and review of literature. Monaldi arch chest dis","volume":"90","author":"Rahman","year":"2020","journal-title":"Arch Monaldi Mal Torace"},{"key":"2026032313434931100_ref12","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1752-1947-6-28","article-title":"Melioidosis presenting with mediastinal lymphadenopathy masquerading as malignancy: a case report","volume":"6","author":"Saravu","year":"2012","journal-title":"J Med Case Rep"},{"key":"2026032313434931100_ref13","first-page":"102048","article-title":"EBUS-TBNA diagnosis of mediastinal melioidosis in patient presented with lymphadenopathy and SVC thrombosis: a rare manifestation in non-diabetic patient","volume":"50","author":"Jirawat","year":"2024","journal-title":"Respir Med Case Rep"},{"key":"2026032313434931100_ref14","doi-asserted-by":"publisher","first-page":"93","DOI":"10.2149\/tmh.2014-42","article-title":"Mediastinal lymphadenopathy: melioidosis mimicking tuberculosis","volume":"43","author":"Chan","year":"2015","journal-title":"Trop Med Health"},{"key":"2026032313434931100_ref15","doi-asserted-by":"publisher","first-page":"e0008659","DOI":"10.1371\/journal.pntd.0008659","article-title":"2020 review and revision of the 2015 Darwin melioidosis treatment guideline; paradigm drift not shift","volume":"14","author":"Sullivan","year":"2020","journal-title":"PLoS Negl Trop Dis"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/3\/omag032\/67483581\/omag032.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/3\/omag032\/67483581\/omag032.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:43:55Z","timestamp":1774287835000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omag032\/8537677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,23]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omag032","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"omag032"}}