# Chronic Osteomyelitis of the Femur: A Rare Manifestation of Melioidosis

## TL;DR

A rare case of melioidosis presenting as chronic osteomyelitis in the femur is reported, highlighting unusual clinical features and treatment.

## Contribution

This case report adds to the limited literature on osteomyelitis as a rare manifestation of melioidosis.

## Key findings

- Melioidosis was confirmed by blood cultures showing B. pseudomallei.
- Osteomyelitis of the femur was the primary clinical manifestation in this patient.
- The patient's altered sensorium was linked to severe hyponatremia.

## Abstract

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. While pulmonary and cutaneous manifestations are common, osteomyelitis is a relatively rare presentation. This case report describes a middle-aged man who presented with fever, fluctuating sensorium, and right knee pain for five months.

Blood cultures grew B. pseudomallei, confirming the diagnosis of melioidosis. Imaging revealed osteomyelitis of the right femur as the primary clinical manifestation. The patient's altered sensorium was attributed to severe hyponatremia, a complication often associated with poor clinical outcomes in melioidosis. He was managed with culture-guided intravenous antibiotic therapy for two weeks, followed by oral eradication therapy for three months.