Melioidosis as a Cause of Multifocal Osteomyelitis

Melioidosis is a tropical disease caused by the saprophyte Burkholderia pseudomallei. Infection can be acquired by ingestion, inhalation, or wound contamination. Typically, the healthy host is symptom-free and acute disease develops in patients with coexistent diabetes, renal impairment, chronic pulmonary disease, and immunosuppression. We report a culture-proven case of multifocal osteomyelitis caused by B. pseudomallei in a patient of Southeast Asian origin. The presentation with osteomyelitis was preceded a week earlier by development of a community-acquired pneumonia. Our case alerts clinicians about this unusual etiology of osteomyelitis that is a result of reactivation of latent B. pseudomallei.