Craniospinal MRI patterns in neuro-melioidosis across Indian centers

In 33 patients with confirmed neuro-melioidosis, brain MRI showed brainstem involvement in 57.6%, white matter tract dissemination in 66.7%, and diffusion restriction in 72.7%; recognizing this pattern may prompt earlier microbiologic testing.

• Retrospective multicenter case series of 33 microbiologically confirmed patients across seven Indian tertiary centers (2019–2025).
• Supratentorial involvement 81.8%, infratentorial 60.6%, multifocal 60.6%; spinal involvement 42.4%, including simultaneous brainstem and intramedullary disease 33.3%.
• Initial misdiagnosis 24.2%; 30.3% received corticosteroids before definitive diagnosis; in-hospital mortality 12.1%.

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