Burkholderia pseudomallei sepsis with osteoarticular melioidosis of the hip in a patient with diabetes mellitus

Abstract

Melioidosis is caused by the tropical soil pathogen Burkholderia pseudomallei Infection, usually in the form of pneumonia, disproportionately affects people with a risk factor for immune dysregulation and mortality remains high even with treatment. Climate change and increasing rates of diabetes render the populations of endemic areas increasingly vulnerable to the disease, which is emerging as a serious global health threat. We present here a case of a 68-year-old man from northern Australia with sepsis and osteoarticular melioidosis of the hip, and explore the links between diabetes mellitus and melioidosis, particularly with respect to musculoskeletal infection.

Keywords: bone and joint infections; diabetes; tropical medicine (infectious disease).

Figure 1

Ultrasound of right hip, with left side done for comparison, showing a 6 mm partially compressible fluid collection along the anterior right hip joint.

Figure 2

T2-weighted images from MRI scan from day 7 post-washout of right hip joint showing increased signal in the acetabular margin of the iliac bone, right thigh muscles, gluteal muscle adjacent to the iliac bone on right side. There was minimal residual increase in fluid in right hip joint compared with left.