Occlusive retinal vasculitis in an immunocompetent woman: rare presentation of ocular melioidosis

Burkholderia pseudomallei is a known great mimicker responsible for melioidosis. Melioidosis presents with a wide spectrum of clinical presentations in various organs including the eye. Ocular involvement in melioidosis is unusual, with eyelid and orbital infection as the commonest presentation. We describe a 41-year-old, healthy woman who complained of reduced vision in her left eye. On examination, vision in the left eye was 6/9. There was evidence of occlusive retinal vasculitis on fundoscopy examination. Fundus fluorescein angiogram showed extensive capillary fallout. Diagnosis was established by a rise in the serum antibody titre for the bacterium and further supported by clinical improvement of vision after completion of treatment antibiotics: third-generation cephalosporin and combination of amoxicillin and clavulanic acid. Sectoral panretinal photocoagulation at the capillary fallout area successfully arrested the sequelae of retinal ischaemia. Occlusive retinal vasculitis is a rare presentation of melioidosis. Early prompt diagnosis of ocular melioidosis in an immunocompetent individual helps prevent visual-related morbidity. The ability of this bacteria to cause recurrent infection in an endemic area should not be under-estimated