Melioidosis in sickle cell hemoglobinopathies in eastern India: Cavitating pneumonia and immune susceptibility - a case series-based insight.

Melioidosis, caused by Burkholderia pseudomallei, is an emerging infection in the tropics. Most of the melioidosis patients have underlying co-morbidities or occupational exposures. Hemoglobinopathies, such as thalassemia, are established risk factors for melioidosis; however, the association of SCD with melioidosis is infrequently reported. We report two culture-confirmed melioidosis cases from eastern India: a 58-year-old male with SCD on hydroxyurea and another 44-year-old with sickle cell trait, both presenting with cavitary lung lesions mimicking tuberculosis. SCD-related functional asplenia may heighten susceptibility. These cases emphasise the need for clinical vigilance in endemic areas and further research into SCD/SCT-associated immune vulnerabilities.