A rare case of an infected urethral diverticulum due to urinary melioidosis

Abstract

Melioidosis infecting a periurethral diverticulum and behaving as an abscess is a rare complication. A 76-year-old woman presented with pelvic pain, dysuria and urinary frequency. CT identified a large periurethral cystic collection and melioidosis was cultured in her urine. Cystoscopy revealed communication between urethra and diverticulum, requiring multiple transvaginal aspirations for re-accumulation and relapsing symptoms. No risk factors for melioidosis were identified, and was likely that isolated urinary infection is due to her urinary tract pathology. This challenging case with a rare pathogen highlights management and source control of melioidosis may need to adapt to anatomical variations promoting abscess reformation.