Empyema thoracis in melioidosis successfully treated with medical therapy

Melioidosis is endemic in Asia and it is also a great mimicker. A high index of suspicion is required in making the diagnosis. We reported a case of empyema thoracis secondary to melioidosis which was successfully treated using intravenous ceftazidime for 21 days during intensive phase, followed by maintenance therapy using Co-trimoxazole for 20 weeks. Apart from that, intrapleural streptokinase was used to promote drainage of empyema. Patient recovered well with evidence of resolution of empyema on chest imaging.