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Submitted: 2025-05-14
DOI: 10.35119/myjo.v8i2.490
Case Reports
Published: 2026-06-23

Ocular melioidosis: a diagnostic challenge with devastating visual consequences

Department of Ophthalmology, Hospital Tuanku Ampuan Najihah, Kuala Pilah, Negeri Sembilan, Malaysia
Department of Ophthalmology, Hospital Tuanku Ampuan Najihah, Kuala Pilah, Negeri Sembilan, Malaysia
Department of Ophthalmology, Hospital Tuanku Ampuan Najihah, Kuala Pilah, Negeri Sembilan, Malaysia
Department of Ophthalmology, Faculty of Medicine, Hospital Canselor Tuanku Muhriz UKM, Cheras, Kuala Lumpur, Malaysia
Burkholderia pseudomallei endophthalmitis ocular melioidosis

Abstract

Background: Melioidosis is a multi-system infectious disease caused by Burkholderia pseudomallei. Ocular involvement in melioidosis is rare, with a reported prevalence of less than 2%. It frequently affects adults with diabetes. For severe melioidosis, ceftazidime remains the first-line treatment, followed by extended maintenance therapy to reduce the risk of relapse and recurrence.

Case presentation: A 58-year-old man, presented with a 4-day history of pain, redness and photophobia in the right eye. He had diabetes with a history of disseminated melioidosis. Ocular examination showed conjunctival injection, hypopyon in the anterior chamber, and elevated intraocular pressure in the right eye. A conjunctival culture and sensitivity swab found Burkholderia pseudomallei. He was treated with intravenous ceftazidime followed by oral trimethoprim-sulfamethoxazole and responded well to treatment.

Conclusion: Early diagnosis guided by a high index of clinical suspicion as well as prompt treatment are crucial for favorable outcomes.