Synonyms: central nervous system meliodosis, CNS meliodosis
Distribution: Southeast Asia and northern Australia
Clinical pictures:
(1) one or multiple intra-cerebral abscesses with headache, seizure, raised intracranial pressure (ICP) and/or coma
(2) brainstem encephalitis
(3) aseptic meningitis
(4) Guillain-Barre-like syndrome
Affected patients:
(1) often have one or more risk factors for meliodosis (diabetes, etc)
(2) have a source of organisms (sinusitis, otitis, bacteremia)
Implications for the patient:
(1) high mortality rate
(2) severe neurologic impairment
Management requirements:
(1) drainage of intracerebral abscesses
(2) prolonged parenteral antibiotic therapy, up to 12 weeks
