Cutaneous melioidosis: A case report from Mali

Abstract

Melioidosis is a bacterial zoonosis transmitted by air and skin, caused by a telluric bacillus Burkholderia pseudomallei. It is a severe infection due to its visceral complications. It is mainly observed in Southeast Asia and Northern Australia. In Africa and particularly in Mali, it is rarely observed. We report the case of a 25 year old Malian man, a mechanic driver with no particular history, who was seen in August 2021 for persistent papular lesions of the face following a long vehicle breakdown in the bushes of Kita, a region of southern Mali with high rainfall. On examination, the patient was in good general condition, had a fever of 38°C and a BMI of 22. On the skin, papulo-pustular and nodular lesions were observed in places, predominantly on the face and some on the back. The rest of the clinical examination was normal. The bacteriological examination of the pus showed the presence of numerous Burkholderia pseudomallei colonies and the antibiogram showed a sensitivity of the germ to imipenem and intermediately to amoxicillin-clavulanic acid. The rest of the work-up was normal. The patient was treated with amoxicillin-clavulanic acid with a disappearance of the lesions in 15 days. Melioidosis should always be considered in the presence of papulo-nodular and pustular lesions in the context of a stay in a humid area.