Splenic abscesses in a returning traveler

Burkholderia, an aerobic gram-negative rod, is the causative organism behind melioidosis and is a common soil and water organism found predominantly in South-East Asia. We report the case of a 68 year-old man returning from an extended trip to the Philippines, with splenic hypodense lesions on abdominal computer tomography scan, later confirmed to be culture-positive for Burkholderia pseudomallei. The patient was treated with a course of intravenous ceftazidime followed by eradication therapy with oral doxycycline and trimethoprim-sulfamethoxazole. He recovered with complete resolution of symptoms at follow up. In a returning traveler from an endemic area, melioidosis should be considered as part of the differential for any febrile illness with abscesses.