{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:09:17Z","timestamp":1785312557330,"version":"3.55.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Dermatol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Melioidosis is an emerging infection in South Asia caused by <jats:italic>Burkholderia pseudomallei<\/jats:italic> with various clinical presentations that include pneumonia, bacteraemia, arthritis, and deep-seated abscesses. Various cutaneous manifestations have been described in association with melioidosis. However Sweet Syndrome secondary to melioidosis has not been reported in the literature. Herein we describe the first case of Sweet syndrome secondary to melioidosis.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 53-year-old previously healthy Sri Lankan female presented with high-grade fever, painful oral ulcers, odynophagia and multiple bilateral cervical lymphadenopathies for 1 month. She also had a loss of appetite and weight. She had oral ulcers and bilateral blepharitis. Dermatological examination revealed multiple tender papules with a mamillated appearance and targetoid lesions with a yellowish centre over the face, upper trunk and upper limbs. She also had multiple tender subcutaneous nodules over the extensor aspect of upper limbs. Her inflammatory markers were significantly elevated. Aspirate from a submental lymph node abscess revealed the growth of <jats:italic>Burkholderia pseudomallei.<\/jats:italic> Melioidosis antibody titer was &gt;\u200910,240. The histology of the skin lesions of the face and left forearm showed a prominent neutrophilic infiltrate in the dermis and the morphological features were in favour of Sweet syndrome with panniculitis. She was started on intravenous meropenem 2\u2009g daily and showed rapid clinical improvement with the disappearance of skin lesions as well as a reduction in inflammatory markers.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Sweet syndrome is an uncommon inflammatory disorder known to be associated with upper respiratory tract and gastrointestinal infections, malignancies and the use of certain drugs. Melioidosis is an emerging infection with various cutaneous manifestations. This is the first case of melioidosis causing the secondary sweet syndrome. It emphasizes the importance of considering melioidosis as a potential aetiology in patients with Sweet syndrome.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12895-019-0096-2","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T06:58:19Z","timestamp":1575269899000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A rare case of Sweet syndrome secondary to melioidosis"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6747-3679","authenticated-orcid":false,"given":"Sahathevan","family":"Vithoosan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balendran","family":"Thanushah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paramarajan","family":"Piranavan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayal","family":"Gamlaksha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harindra","family":"Karunatilake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananda","family":"Jayanaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"issue":"5","key":"96_CR1","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1086\/590931","volume":"47","author":"KB Gibney","year":"2008","unstructured":"Gibney KB, Cheng AC, Currie BJ. Cutaneous Melioidosis in the tropical top end of Australia: a prospective study and review of the literature. Clin Infect Dis. 2008;47(5):603\u20139.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"96_CR2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3390\/tropicalmed3010022","volume":"3","author":"EM Corea","year":"2018","unstructured":"Corea EM, de Silva AD, Thevanesam V. Melioidosis in Sri Lanka. Trop Med Infect Dis. 2018;3(1):22. https:\/\/doi.org\/10.3390\/tropicalmed3010022 Published 2018 Feb 21.","journal-title":"Trop Med Infect Dis"},{"issue":"1","key":"96_CR3","doi-asserted-by":"publisher","first-page":"47","DOI":"10.4038\/sljid.v2i1.3795","volume":"2","author":"GN Perera","year":"2012","unstructured":"Perera GN, Dias L, Kulatunga A, Corea E, Masakorala J. A case report of Melioidosis. Sri Lankan J Infect Dis. 2012;2(1):47\u201351.","journal-title":"Sri Lankan J Infect Dis"},{"issue":"2","key":"96_CR4","first-page":"154","volume":"11","author":"D Sfrijan","year":"2016","unstructured":"Sfrijan D, Visan S-M, Diaconu B, Zurac S, Scurtu C. A case of Sweet\u2019s syndrome secondary to Myelodysplastic syndrome - diagnostic and treatment challenges. Maedica (Buchar). 2016;11(2):154\u20137.","journal-title":"Maedica (Buchar)"},{"issue":"9","key":"96_CR5","first-page":"WD01","volume":"10","author":"B Achappa","year":"2016","unstructured":"Achappa B, Madi D, Vidyalakshmi K. Cutaneous melioidosis. J Clin Diagn Res. 2016;10(9):WD01\u20132.","journal-title":"J Clin Diagn Res"},{"key":"96_CR6","doi-asserted-by":"publisher","first-page":"17107","DOI":"10.1038\/nrdp.2017.107","volume":"4","author":"WJ Wiersinga","year":"2018","unstructured":"Wiersinga WJ, Virk HS, Torres AG, Currie BJ, Peacock SJ, Dance DAB, Limmathurotsakul D. Melioidosis. Nat Rev Dis Primers. 2018;4:17107. https:\/\/doi.org\/10.1038\/nrdp.2017.107 Review.","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"96_CR7","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1080\/08998280.2015.11929190","volume":"28","author":"R Soto","year":"2015","unstructured":"Soto R, Levy Y, Krause JR. Sweet syndrome and its association with hematopoietic neoplasms. Proc (Baylor Univ Med Cent). 2015;28(1):62\u20134.","journal-title":"Proc (Baylor Univ Med Cent)"},{"issue":"11","key":"96_CR8","first-page":"1081","volume":"15","author":"A Nofal","year":"2017","unstructured":"Nofal A, Abdelmaksoud A, Amer H, Nofal E, Yosef A, Gharib K, et al. Sweet\u2019s syndrome: diagnostic criteria revisited. J Dtsch Dermatol Ges. 2017;15(11):1081\u20138.","journal-title":"J Dtsch Dermatol Ges"},{"issue":"1","key":"96_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1750-1172-2-34","volume":"2","author":"PR Cohen","year":"2007","unstructured":"Cohen PR. Sweet\u2019s syndrome - a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. 2007;2(1):1\u201328.","journal-title":"Orphanet J Rare Dis"}],"container-title":["BMC Dermatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12895-019-0096-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12895-019-0096-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12895-019-0096-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T19:33:25Z","timestamp":1606764805000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcdermatol.biomedcentral.com\/articles\/10.1186\/s12895-019-0096-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["96"],"URL":"https:\/\/doi.org\/10.1186\/s12895-019-0096-2","relation":{},"ISSN":["1471-5945"],"issn-type":[{"value":"1471-5945","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"6 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not obtained, as it was a case report. Written consent only obtained.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16"}}