Uncommon clinical presentations of melioidosis in children: 2 cases with sore throat and 1 case with urticarial rash.

Common clinical presentations of melioidosis in children include suppurative parotitis, lymphadenitis, skin infection and septicemia with pneumonia. Here we describe three cases with uncommon presentations of melioidosis seen among children attending a university hospital in northeastern Thailand. Two patients presented with pharyngitis and subsequently developed cervical lymphadenitis. Another patient presented with high fever and generalized urticarial rash. A pharyngeal culture in each of the first 2 patients and a blood culture and culture of the discharge from the wound of the third patient grew Burkholderia pseudomallei. All patients recovered with treatment. Their clinical presentations, initial diagnosis, treatment, clinical course and outcomes are described. Physicians caring for children living in, or returning from, melioidosis endemic areas should be aware of these uncommon presentations.