TITLE:
Reaching a Diagnosis of Pulmonary Melioidosis in a Resource Limited Setting
AUTHORS:
Francis T. Mawie, Akeem Abia, Ed P. F. IJzerman, Iswardath Thakoer, Fitzgerald A. Gopie
KEYWORDS:
Burkholderia cepacia, Burkholderia pseudomallei, Burkholderia thailandensis, Tuberculosis
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.13 No.4,
December
17,
2025
ABSTRACT: We report chronic pulmonary melioidosis in a 69-year-old diabetic farmer in Suriname, initially misidentified as Burkholderia cepacia complex infection by MALDI-TOF mass spectrometry. Standard commercial databases lack Burkholderia pseudomallei spectra due to biosafety restrictions and limited endemicity in database development regions. The patient presented with hemoptysis and a cavitating upper-lobe consolidation mimicking tuberculosis. Clinical suspicion based on occupation, radiological findings, and known presence of Burkholderia thailandensis (a less virulent species within the B. pseudomallei complex) in Surinamese soil led to empiric melioidosis treatment, with dramatic response. This case highlights critical gaps in diagnostic capabilities for melioidosis in emerging endemic regions and underscores the need for increased clinical awareness as climate change potentially expands the geographic distribution of B. pseudomallei.