The role of Granulocyte Colony-Stimulating Factor and carbapenem therapy in severe melioidosis: A case report from Malaysia

Melioidosis is a fatal disease endemic in Southeast Asia and Australia. Type 2 diabetes mellitus is one of the main risk factors for acquiring this infectious disease. We described a case of severe melioidosis in a 31-year-old female patient with multiple hepatosplenic abscesses and underlying type 2 diabetes mellitus. The blood culture showed positive results to Burkholderia pseudomallei only after one month of on and off fever experienced by the patient. A splenectomy was done to prevent the development of peritonitis. The use of granulocyte colony-stimulating Factor (G-CSF) in addition to shifting from ceftazidime to meropenem therapy played an effective role in the recovery of the patient. In this case report we reviewed the literature on the impaired immunity in type 2 diabetic patient that put the patient on risk of acquiring melioidosis and the suggested role of G-CSF and carbapenem therapy.