Neuromeliodosis—A Tropical Illness Presenting as Meningoencephalitis with Unusual Brain Imaging

摘要

A56-year-old lady, hailing fromacoastalareainWestern India,a known case of diabetes mellitus, presented with feverand dry cough for 1 week. She was given ashortcourse ofantibioticsand symptomatictreatmentatalocal hospital, followingwhich her symptoms resolved. Aweek later, she onceagain began spiking fever. Shealso noticed theacute weakness oftheright upperand lower limb which affected herambulation, and she was referred to our tertiary carecenter. On initialevaluation, she was febrile, pale with tachycardia. Her neurologicalexamination revealed the power of 3 (MRC Grading) in theright upperand lower limb with diminished reflexes on therightside with an extensor plantar response. Therespiratory examrevealed basal crepitations. Musculoskeletalexamination revealed swelling oftheright kneethat waserythematousand tender.