Melioidosis in children from southern coastal India

Melioidosis is an infectious disease caused by a gram-negative bacillus, Burkholderia pseudomallei. It is known to be endemic in Southeast Asia and Northern Australia. There is a recent surge in cases from coastal India. We hereby report four episodes of Melioidosis in 3 children with one child having a recurrent episode. One child was male and two were female, with all the children aged more than ten years (range 10-14years). Fever was the most common symptom followed by abdominal and bone pain in 50% of episodes. Immunocompromised state (post-splenectomy status and steroid therapy) as a predisposing factor was present in 2 children. One child presented with septicemia and succumbed within 72 hours of admission. Ceftazidime/Meropenem and cotrimoxazole were used in intensive and eradication phase respectively. A comprehensive knowledge and high index of suspicion are required to diagnose Melioidosis. Prolonged treatment course with appropriate antibiotics would help in minimizing the mortality and morbidity in children.