Chang CY, Nor Aswan FA, Muhamad Yazid MA. Disseminated melioidosis presenting with multifocal thoracic aortic mycotic aneurysms: A case report. World J Clin Cases 2026; 14(5): 118498 [DOI: 10.12998/wjcc.v14.i5.118498]
Corresponding Author of This Article
Chee Yik Chang, MRCP, Department of Medicine, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, Johor Bahru 80100, Johor, Malaysia. ccyik28@gmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 16, 2026 (publication date) through Feb 10, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Chang CY, Nor Aswan FA, Muhamad Yazid MA. Disseminated melioidosis presenting with multifocal thoracic aortic mycotic aneurysms: A case report. World J Clin Cases 2026; 14(5): 118498 [DOI: 10.12998/wjcc.v14.i5.118498]
Chee Yik Chang, Fatin Aqilah Nor Aswan, Department of Medicine, Hospital Sultanah Aminah, Johor Bahru 80100, Johor, Malaysia
Muhamad Aibaq Muhamad Yazid, Department of Radiology, Hospital Sultanah Aminah, Johor Bahru 80100, Johor, Malaysia
Author contributions: Chang CY conceived and supervised the study and led the writing and revision of the manuscript; Nor Aswan FA and Muhamad Yazid MA curated the data and drafted the manuscript.
Informed consent statement: The patient provided written consent for the publication of their case details and accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chee Yik Chang, MRCP, Department of Medicine, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, Johor Bahru 80100, Johor, Malaysia. ccyik28@gmail.com
Received: January 13, 2026 Revised: January 24, 2026 Accepted: February 2, 2026 Published online: February 16, 2026 Processing time: 37 Days and 12.4 Hours
Abstract
BACKGROUND
Melioidosis, caused by Burkholderia pseudomallei (B. pseudomallei), is endemic to Southeast Asia and northern Australia, with clinical manifestations ranging from localized infection to life-threatening disseminated disease. Mycotic aneurysm is a rare but serious complication of disseminated melioidosis, associated with high morbidity and mortality.
CASE SUMMARY
We describe a case of a 67-year-old man with diabetes mellitus who presented with B. pseudomallei bacteremia complicated by multiple deep-seated abscesses and multifocal mycotic aneurysms of the descending thoracic aorta. Despite appropriate antimicrobial therapy, serial imaging demonstrated progressive aneurysmal enlargement. Surgical repair was recommended but declined by the patient. He was managed conservatively with prolonged antimicrobial therapy and close clinical and radiological monitoring.
CONCLUSION
This case illustrates the aggressive nature of disseminated melioidosis with vascular involvement and highlights the need for early diagnosis and multidisciplinary management to improve outcomes.
Core Tip: Melioidosis is a potentially severe infectious disease caused by Burkholderia pseudomallei, with clinical manifestations ranging from localized infection to fulminant disseminated disease. Although vascular involvement is an uncommon complication, mycotic aneurysm represents a particularly severe manifestation. Involvement of the thoracic aorta is especially rare and carries a high risk of morbidity and mortality. This case highlights disseminated melioidosis complicated by multifocal mycotic aneurysms of the descending thoracic aorta, emphasizing the need for early recognition, serial imaging, and multidisciplinary management to improve patient outcomes.
