Successful Treatment of Burkholderia pseudomallei without Full Course of Trimethoprim/Sulfamethoxazole due to Drug-induced Pancreatitis: A Case Report from Western India

REPORT(RR36/MIN), tachycardic (HR-124/minute), febrile (100F), conscious, and oriented, and had bilateral crepitation on lung examination. IntroductIonBurkholderia pseudomallei is an uncommon infection which involves multiple organ systems.Lung involvement causing acute respiratory distress syndrome (ARDS) is being reported in many cases.Only few cases have been reported from Gujarat. 1,2If the diagnosis of such an illness is delayed, it carries significant mortality.The firstline treatment involves meropenem followed by trimethoprimsulfamethoxazole (TMP/SMX).TMP/SMX is not without problems with reported hepatotoxicity, thrombocytopenia, allergic reaction, acute kidney injury (AKI), hyperkalemia, etc. Pancreatitis is an uncommon side effect of TMP/SMX.Here, we report a case of melioidosis presenting as community-acquired pneumonia with ARDS with septic shock, where treatment was also complicated by TMP/SMX-induced pancreatitis. case descrIptIonA 27-year-old female coming from Chotila Taluka, Surendranagar district, Gujarat, presented with complaints of fever with chills for 3-4 days.The patient also had diarrhea 3-4 episodes/day and vomiting 1-2 episodes/day with pain in the abdomen for 3 days.The patient was admitted to a hospital near to her home for 3 days.She was shifted to Zydus Hospitals, Ahmedabad, for further management.On examination, she was tachypneic