From small wound to severe illness: Rare melioidosis case shocks doctors

Musaddik Abbas Tandel (in blue shirt) with his family after recovering from a life-threatening infection. Pics/By Special Arrangement

Thirty years after moving to Saudi Arabia for work, 58-year-old Musaddik Abbas Tandel returned home to Raigad hoping for a quiet retired life. Instead, a minor cut between his toes and routine unpacking work set off a rare and potentially fatal infection - melioidosis, caused by soil-borne bacteria. "I didn't think much of the cut… it was small. But a few days later, the pain started. My knee swelled, and I began having difficulty breathing," Tandel said.

A rare diagnosis

Melioidosis remains extremely uncommon and often under diagnosed. "This is only the fourth case I've seen in decades of practice," said Dr Savla. Other specialists, including doctors from Sir HN Reliance Foundation Hospital and Lilavati Hospital, said they had not encountered such cases in their clinical experience, highlighting its rarity and the difficulty in identifying it early.

Dr Honey Savla, consultant-internal medicine at Wockhardt Hospitals, who treated the patient for melioidosis and related complications

Why this case stands out

The infection entered through a minor cut, worsened through dust inhalation, and progressed into a multi-system emergency, affecting the leg and lungs. Its symptoms initially mimicked more common diseases, delaying targeted treatment.

Musaddik Abbas Tandel, who contracted a rare melioidosis infection after returning to Raigad from Saudi Arabia

Outcome

"I am now pain-free, walking independently and breathing normally," Tandel said, adding that he continues medication for blood clot management.

What followed was a rapid and dangerous escalation

As symptoms worsened, further tests revealed something far more serious than a routine infection. "When he came to us, he had severe knee pain, swelling and low oxygen levels. Tests showed Deep Vein Thrombosis, and the clot had already travelled to the lungs, causing a pulmonary embolism," said Dr Honey Savla, consultant-internal medicine, Wockhardt Hospitals

Doctors traced the source back to a combination of exposures: dust inhaled while handling old furniture and muddy water entering through the open wound. The culprit was Burkholderia pseudomallei, a bacterium found in soil and contaminated dust. Tandel underwent emergency surgery to remove the clot and stabilise his breathing, followed by a surgical cleaning of the infection. Despite the intervention, persistent evening fevers raised fresh concerns.

"We treated him with intensive intravenous antibiotics for two weeks, followed by a course of oral medication to completely kill the infection. Because if not treated completely, this infection can relapse months later," said Dr Savla.