Melioidosis, caused by Burkholderia pseudomallei, is an under-diagnosed tropical infection that often mimics tuberculosis and other chest diseases. We report the case of a 42-year old diabetic female who presented with fever and pneumonia and who developed septic arthritis. Blood, joint fluid, and abscess cultures grew B. pseudomallei . Initial treatment was with meropenem but owing to a suboptimal response, the patient was changed to a combination therapy with ceftazidime which led to clinical and biochemical improvement. She was then discharged with a three month course of co-trimoxazole for eradication. This case illustrates the multifocal nature of melioidosis and the diagnostic challenges even in endemic areas, emphasizing the need for high clinical suspicion as well as the need for prompt and aggressive antimicrobial therapy for optimal outcome.
Joseph et al. (Wed,) studied this question.