Abstract
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Highlights
Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a saprophytic gramnegative bacillus acquired by inhalation or inoculation through contaminated soil or water
We describe a rare case of melioidosis presenting as a septic arthritis of the left hip with abscess formation without any other identifiable focus of sepsis
The patient complained of a low-grade fever with a left hip pain which appeared a week after the onset of fever. His hip movements became more painful and restricted which left him confined to bed. He was initially admitted to a local hospital where he was treated as septic mono-arthritis of left hip joint with intravenous flucloxacillin without apparent resolution, he was transferred to a tertiary care hospital for specialised management
Summary
Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a saprophytic gramnegative bacillus acquired by inhalation or inoculation through contaminated soil or water. We describe a rare case of melioidosis presenting as a septic arthritis of the left hip with abscess formation without any other identifiable focus of sepsis. The culture of this fluid revealed a growth of a gram-negative bacillus which was resistant to aminoglycosides and polymyxin B which later was identified as Burkholderia pseudomallei His serum antibody titre for melioidosis became positive (1 : 640 by Indirect Haemagglutination Assay) on two occasions. He was commenced on Intravenous meropenam 1g 8 h hourly, oral trimethoprim-sulfamethoxazole 1440 mg twice daily and with the help of orthopaedic team hip joint arthrotomy and abscess drainage was performed twice. He fully recovered within three months without any relapses
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