ABSTRACT
Melioidosis is an emerging infectious disease in tropical countries. Although it is endemic in northern Australia and southeast Asia, there are increased reports of melioidosis from different parts of the world because of international travel. Bone and joint involvement in melioidosis is uncommon but can be potentially devastating unless diagnosed and treated early. Septic arthritis, osteomyelitis, and abscess are common clinical presentations. Lower limb joints and bones are more frequently involved. The osteomyelitis caused by B. pseudomallei is not clinically or radiologically different from common pathogens such as Staphylococcus and Streptococcus. Other than an acute suppurative infection, it can present as a chronic granulomatous inflammatory lesion mimicking tuberculosis. These non-specific clinical, radiological, and histopathological features make diagnosing it more challenging. Isolation of the organism from the synovial fluid or tissue material is the only way of diagnosis. Increased awareness about the disease, proper tissue specimen collection, transportation, proper handling at the laboratory, and growing the organism in appropriate culture media are paramount for diagnosis. Aggressive surgical debridement to remove all dead necrotic material or pus is essential from the surgeon's perspective, but at the same time, aggressive medical treatment with appropriate antibiotics is essential. Unfortunately, no vaccine is available to date against melioidosis.
