Disseminated Melioidosis Complicated by Dural Venous Sinus Thrombosis: A Case Report

Abstract

Melioidosis is a potentially fatal endemic infection caused by the Gram-negative bacterium Burkholderia pseudomallei. The disease may present with a wide spectrum of clinical manifestations, including pneumonia, visceral abscesses, and septicemia. Neurological complications are uncommon but have been reported, with dural venous sinus thrombosis being a particularly rare manifestation. We describe a case of a 55-year-old Malay woman with underlying diabetes mellitus and hypertension who presented with a one-week history of fever, confusion, back pain, and dyspnoea. Blood cultures grew Burkholderia pseudomallei, and imaging demonstrated disseminated infection with multiple splenic abscesses and pulmonary septic emboli, as well as dural venous sinus thrombosis. The patient was initially treated with intravenous meropenem, followed by ceftazidime and oral trimethoprim-sulfamethoxazole as part of eradication therapy. Therapeutic anticoagulation with enoxaparin was also initiated. Follow-up imaging demonstrated significant resolution of the visceral abscesses and pulmonary lesions.