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

Burkholderia pseudomallei is a known great mimicker responsible for melioidosis. 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. 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 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 underestimated.