A Rare Presentation of Genitourinary Melioidosis: Isolation of Burkholderia pseudomallei From a Prostatic Abscess in a Patient From Puducherry.

Melioidosis, caused by the facultative intracellular Gram-negative bacterium Burkholderia pseudomallei, presents with diverse clinical manifestations ranging from asymptomatic carriage to life-threatening infections. We report a rare case of genitourinary melioidosis presenting as a prostatic abscess in a 70-year-old male patient with chronic kidney disease from southern India. The patient presented with fever, breathlessness, and scrotal swelling. Imaging revealed multiple prostatic abscesses with urine cultures growing B. pseudomallei, confirmed by biochemical tests and automated identification systems. The patient was empirically treated with IV clindamycin (600 mg q8h) and IV piperacillin-tazobactam (4.5 gm q8h) along with inotropes and fluids. Timely confirmation of genitourinary melioidosis led to escalation of antibiotics to IV ceftazidime 2 gm q6h for four weeks, followed by oral trimethoprim-sulfamethoxazole for three months, leading to complete clinical and microbiological recovery. This case highlights the importance of early recognition and accurate microbiological diagnosis of B. pseudomallei in atypical presentations to ensure timely and effective therapy, especially in endemic regions and in patients with risk factors such as chronic kidney disease.