gram negative bacilli, liver abscess, septicemia
S Banerjee. Liver Abscess Due To Unusual Gram Negative Bacilli: Burkholderia Pseudomallei?. The Internet Journal of Microbiology. 2008 Volume 6 Number 1.
Melioidosis is an infectious disease of humans and animals caused by
A 44 years old diabetic male, resident of a village near Nagunur, presented with a high grade fever, pain in abdomen since two weeks, loose motions and with a history of jaundice. On examination, he showed mild hypochromic anaemia, total serum bilirubin was 1.3 IU/L (0.2-1.0 normal), Alkaline phosphatase was 256 IU/L (42-192 normal). Ultrasound showed hypoechoic lesions in right lobe (76 x 67 mm) with normal gall bladder, pancreas, spleen & both kidneys. About 50ml pus aspirated from the abscess was received by microbiology lab for culture.
The Gram stain of pus showed gram negative bacilli which grew on blood agar as pin-point, non-haemolytic, flat colonies. Gram staining of culture showed typical bipolar staining. The organism was motile, Oxidase & Catalase positive, a non fermenter & utilized citrate and did not produce Indole, H2S or hydrolyzed Urea. Presumptively the organism was categorized as Pseudomonas spp. other than
A 50 years old diabetic male was admitted to the hospital with fever and abdominal pain since one week. Similar to first patient, this patient also had hypochromic anaemia, and elevated levels of serum bilirubin (1.32 IU/L) and alkaline phosphatase (261 IU/L). Ultrasound showed presence of Pyogenic liver abscess with hepatomegaly. The patient underwent the USG guided aspiration and about 10 ml purulent material was received by microbiology lab for culture. Similarly when grown on culture, organism was found as gram negative diplobacilli with typical bipolar staining. The characterization scheme followed in the similar manner and led to the presumptive identification of
Although we could not confirm the isolates serologically as the cultures had become non viable before they could be sent for serotyping, but we strongly suspect the same organism as causative agent based on other evidences.