Tunnel sign in patients with melioidosis: a case series from South India.

INTRODUCTION

The tunnel sign (linear contrast enhancement along the corticospinal tract) can aid in the early diagnosis of neuromelioidosis, a potentially fatal condition requiring urgent diagnosis.

METHODOLOGY: We retrospectively analyzed the hospital data of all patients with culture-confirmed melioidosis between 2018 and 2023 in a tertiary care hospital in South India. MRI scans of patients with neuromelioidosis were reviewed for the presence of the tunnel sign.

RESULTS

Of the 177 patients with melioidosis, 21 had possible neurological involvement. Seven had confirmed neuromelioidosis. Of the six patients with neuromelioidosis, where an MRI scan was available, a tunnel sign was noted in four.

CONCLUSION

We report this study to create awareness amongst physicians to look for this sign in patients with suspected neuromelioidosis.