Introduction: Patients with melioidosis can present with a combination of fever, respiratory distress and focal involve-ment. Focal involvement of bone and joint is, however, rare in patients with melioidosis. This study aimed to charac-terize patients with osteoarticular melioidosis. Patients and Methods: This was a retrospective review of records of all adult patients diagnosed with culture-positive osteoarticu-lar melioidosis over three years. The clinical, laboratory and treatment details were recorded in a predefined case-record form and analyzed. Results: Of the 11 patients with osteo-articular melioidosis, 55% (n=6) had concurrent pulmonary involvement. The patients were classified as isolated osteo-myelitis (n=3), isolated arthritis (n=3), and both osteomy-elitis and septic arthritis (n=5). Of eight patients with joint involvement, 87.5% had monoarthritis. A single bone was involved in 75% of the patients with bone involvement (n=8). Concomitant myositis was seen in 36.4% (n=4) of the cases. Local debridement of the involved bone or joint was done in 54.5% (n=6) of the cases. Combination therapy with ceftazidime/meropenem and cotrimoxazole was predomi-nantly used as intensive therapy for a mean of 3+1.3 weeks. Monotherapy with cotrimoxazole was used as eradication therapy for a mean of 4.6+2 months. Except for one patient with recurrent disease and one death, all patients were de-clared cured at the end of therapy. Conclusion: Osteoarticu-lar melioidosis should be suspected in high-risk individuals from endemic areas with single bone or joint involvement and surrounding myositis. Early diagnosis and prompt ini-tiation of therapy is key to a favourable response.
All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases