{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:58:01Z","timestamp":1791385081844,"version":"4.3.3"},"reference-count":25,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Melioidosis is an emerging tropical infectious disease with diverse clinical manifestations and a high fatality rate. We report a rare case of chronic melioidosis manifesting as pulmonary infection, empyema, and splenic abscess. The patient presented with recurrent chest pain, cough, and abdominal discomfort for 11 months, initially misdiagnosed as common bacterial infection. Computed tomography imaging revealed pulmonary infection, left pleural effusion, and multiple abnormal low-density lesions in and around the spleen. Pleural effusion culture identified\n                    <jats:italic>Burkholderia pseudomallei.<\/jats:italic>\n                    Management included thoracic puncture and catheter drainage, an intensive phase of intravenous ceftazidime, followed by an eradication phase with oral trimethoprim\/sulfamethoxazole. The patient showed clinical and radiological improvements. Clinicians should consider chronic melioidosis in patients with pneumonia and parapneumonic pleural effusion accompanied by splenic abscesses, particularly in patients with diabetes mellitus from endemic areas. Early recognition, definitive diagnosis, and tailored antimicrobial therapy are essential to prevent the progression of severe pneumonia and sepsis.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0143","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:38:30Z","timestamp":1786469910000},"page":"729-733","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Melioidosis Presenting with Pneumonia, Empyema, and Splenic Abscess"],"prefix":"10.4269","volume":"115","author":[{"given":"Yamei","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Hainan, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhou","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Hainan, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Hainan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Hainan, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"3","key":"b1","series-title":"J Travel Med","first-page":"taad039","article-title":"Travel-associated melioidosis: A narrative review","volume":"30","author":"Norman","year":"2023"},{"issue":"1","key":"b2","series-title":"Trends Microbiol","first-page":"105","article-title":"Burkholderia pseudomallei.","volume":"32","author":"Phillips","year":"2024"},{"issue":"2","key":"b3","series-title":"Clin Microbiol Rev","first-page":"e00006-19","article-title":"Human melioidosis","volume":"33","author":"Gassiep","year":"2020"},{"issue":"11","key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e900","article-title":"The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study","volume":"4","author":"Currie","year":"2010"},{"key":"b5","series-title":"Infect Drug Resist","first-page":"163","article-title":"Imported melioidosis in Japan: A review of cases","volume":"11","author":"Hadano","year":"2018"},{"key":"b6","series-title":"IDCases","first-page":"e02255","article-title":"Chronic cutaneous melioidosis with concomitant basal cell carcinoma","volume":"41","author":"Barajas-Ochoa","year":"2025"},{"issue":"2","key":"b7","series-title":"Am J Trop Med Hyg","first-page":"292","article-title":"Sri Lankan national melioidosis surveillance program uncovers a nationwide distribution of invasive melioidosis","volume":"94","author":"Corea","year":"2016"},{"key":"b8","series-title":"Nat Rev Dis Primers","first-page":"17107","article-title":"Melioidosis","volume":"4","author":"Wiersinga","year":"2018"},{"issue":"3","key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e2105","article-title":"Systematic review and consensus guidelines for environmental sampling of Burkholderia pseudomallei.","volume":"7","author":"Limmathurotsakul","year":"2013"},{"key":"b10","series-title":"Nat Microbiol","first-page":"15008","article-title":"Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis","volume":"1","author":"Limmathurotsakul","year":"2016"},{"issue":"2","key":"b11","series-title":"Pathogens","first-page":"149","article-title":"The epidemiology of melioidosis and its association with diabetes mellitus: A systematic review and meta-analysis","volume":"11","author":"Chowdhury","year":"2022"},{"issue":"5","key":"b12","series-title":"Aust J Gen Pract","first-page":"327","article-title":"Melioidosis: An updated review","volume":"48","author":"Chakravorty","year":"2019"},{"issue":"1","key":"b13","series-title":"PLoS One","first-page":"e54961","article-title":"Host responses to melioidosis and tuberculosis are both dominated by interferon-mediated signaling","volume":"8","author":"Koh","year":"2013"},{"issue":"6","key":"b14","series-title":"Curr Probl Diagn Radiol","first-page":"199","article-title":"Thoracic radiologic manifestations of melioidosis","volume":"41","author":"Burivong","year":"2012"},{"issue":"2","key":"b15","series-title":"Saudi J Med Med Sci","first-page":"74","article-title":"Melioidosis: Spectrum of radiological manifestations","volume":"4","author":"Alsaif","year":"2016"},{"issue":"5","key":"b16","series-title":"Radiologia (Engl Ed)","first-page":"484","article-title":"Imaging manifestations of pulmonary melioidosis: A case series","volume":"64","author":"Carrillo-Bayona","year":"2022"},{"issue":"3","key":"b17","series-title":"Curr Opin Pulm Med","first-page":"204","article-title":"Thoracic empyema: Aetiology, diagnosis, treatment, and prevention","volume":"30","author":"Merchant","year":"2024"},{"issue":"10","key":"b18","series-title":"J Formos Med Assoc","first-page":"874","article-title":"Lymphocytic pleural effusion in acute melioidosis","volume":"106","author":"Chung","year":"2007"},{"key":"b19","series-title":"Curr Res Microb Sci","first-page":"100321","article-title":"Abscesses due to melioidosis: A case-based review","volume":"8","author":"Gupta","year":"2025"},{"issue":"1","key":"b20","series-title":"Insights Imaging","first-page":"17","article-title":"Can the imaging manifestations of melioidosis prognosticate the clinical outcome? A 6-year retrospective study","volume":"10","author":"Khiangte","year":"2019"},{"issue":"1","key":"b21","series-title":"J Clin Ultrasound","first-page":"29","article-title":"Visceral organ abscesses in melioidosis: Sonographic findings","volume":"27","author":"Wibulpolprasert","year":"1999"},{"issue":"3","key":"b22","series-title":"Am J Trop Med Hyg","first-page":"522","article-title":"Incidental splenic granuloma due to Burkholderia pseudomallei: A case of asymptomatic latent melioidosis?","volume":"94","author":"Chow","year":"2016"},{"key":"b23","series-title":"Infect Drug Resist","first-page":"2403","article-title":"Chronic splenic melioidosis in a patient with fever of unknown origin diagnosed by metagenomics next-generation sequencing: An emerging cause and literature review","volume":"16","author":"Sheng","year":"2023"},{"issue":"7","key":"b24","series-title":"PLoS Negl Trop Dis","first-page":"e0008278","article-title":"Prolonged intermittent fever and massive splenomegaly in a miner working in the tropical jungle, China","volume":"14","author":"Liu","year":"2020"},{"issue":"2","key":"b25","series-title":"J Ayub Med Coll Abbottabad","first-page":"348","article-title":"Burkholderia pseudomallei as the predominant cause of splenic abscess in Kapit, Sarawak, Malaysian Borneo","volume":"35","author":"Chang","year":"2023"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/4\/article-p729.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/4\/article-p729.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/4\/article-p729.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:24:41Z","timestamp":1791383081000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/4\/article-p729.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":25,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0143","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}