Musculoskeletal melioidosis: An under-diagnosed entity in developing countries

Abstract Background Melioidosis is a saprophytic infectious disease caused by Gram-negative soil-dwelling bacillus Burkholderia pseudomallei . Materials & methods We report three cases of musculoskeletal melioidosis that are presented to our department from 2011 to 2013. Results One of the patients died due to post-septicemic ARDS. The other two patients have recovered fully and are followed up for minimum of 6 months. There were no recurrences. Conclusions Though musculoskeletal infection due to melioidosis is not common in India, new cases are being reported from Karnataka, Goa and Southern Maharashtra. The need for diagnosing this entity is due to the fact that the septicemic form has a mortality rate that exceeds 90%, and though culture sensitivity report shows susceptibility to various antibiotics, the infection responds to only specific set of antibiotics i.e. intravenous ceftazidime and combination of trimethoprim and sulfamethoxazole.