Light at the End of the Tunnel- A Rare Case of Neuromelioidosis and its Imaging Findings
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Date
2024-11
Journal Title
Journal ISSN
Volume Title
Publisher
International Research Organization for Life & Health Sciences
Abstract
Melioidosis, caused by Burkholderia pseudomallei, is a rare but serious infection with a wide spectrum of clinical manifestations, including central nervous system (CNS) involvement. Neuromelioidosis, which affects the CNS, is uncommon but carries a poor prognosis and high mortality. Here is a case of a 16-year-old girl who presented with fever, hemiparesis, and neurological deficits. Following a magnetic resonance imaging (MRI) brain, a close differential of demyelination versus infection was considered. Despite initial steroid treatment for presumed demyelination, her condition worsened. Her serial MRI brain scans showed progressively characteristic lesions, the rare “tunnel sign,” which along with the clinical picture raised suspicion of an infectious etiology such as Melioidosis. Tissue sampling confirmed the diagnosis. This led to the initiation of targeted antibiotics (meropenem and co-trimoxazole) with the patient improving considerably and the follow-up MRI showing significant regression of lesions. This case highlights the diagnostic challenges of neuromelioidosis, a condition often confused with other CNS infections or autoimmune conditions. Imaging features, particularly the tunnel sign when present, along with microbiological confirmation, are crucial for diagnosis. Timely administration of appropriate antibiotics can significantly improve outcomes. This case report underscores the importance of early recognition and treatment of neuromelioidosis, especially in endemic regions.
Description
Keywords
Antibiotics, Infection, Magnetic resonance imaging, Neuromelioidosis, Steroid, Tunnel sign
Citation
Rakshith V, Chandrasekaran A, Manokaran RK. . Light at the End of the Tunnel- A Rare Case of Neuromelioidosis and its Imaging Findings. International Journal of Scientific Study. 2024 Nov; 12(8): 13-17