Osteomyelitis and septic arthritis from infection with Burkholderia pseudomallei: A 20-year prospective melioidosis study from northern Australia.

The gram-negative organism, Burkholderia pseudomallei, is responsible for the disease melioidosis. Septic arthritis and osteomyelitis due to B. pseudomallei are rare but recognised presentations of the disease.
A prospective database of all cases of melioidosis in the Northern Territory of Australia has been kept since October 1989. Entries to April 2009 were reviewed and cases involving bone and/or joint were investigated. We also present in detail the case reports of 3 presentations of bone and joint melioidosis.
There were 536 presentations of melioidosis during the 20-year study period. Amongst these, there were 13 patients with primary septic arthritis and 7 cases of primary osteomyelitis. Septic arthritis and osteomyelitis were secondary to primary melioidosis elsewhere in 14 and 7 patients respectively. Melioidosis patients with bone/joint involvement were more likely to be Indigenous (p = 0.006) and female (p = 0.023) compared to patients with other presentations of disease.
Timely microbiological diagnosis and prompt treatment of melioidosis involving bone and/or joint with appropriate intravenous antibiotics is important, as is adequate surgical drainage and debridement where indicated. A subsequent protracted course of antibiotic eradication therapy is important to avoid relapse of disease.
AuthorsLevi P Morse, Jonathan Smith, Janak Mehta, Linda Ward, Allen C Cheng, Bart J Currie
JournalJournal of orthopaedics (J Orthop) Vol. 10 Issue 2 Pg. 86-91 ( 2013) ISSN: 0972-978X [Electronic] India
PMID24403756 (Publication Type: Journal Article)

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