Melioidosis presenting as septic arthritis in hip joint of a 60-year old patient - Findings from a hospital-based surveillance in Bangladesh

Sep 29, 2026

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Melioidosis is a fatal bacterial infection caused by Burkholderia pseudomallei, most often presenting as pneumonia, localized abscess, or acute septicemia. Septic arthritis is uncommon and can lead to severe infection. This report describes a 60-year-old diabetic male with fever and acute hip pain, in whom B. pseudomallei was isolated from blood culture and remained sensitive to multiple antibiotics. Following four weeks of parental meropenem and six months of oral cotrimoxazole plus doxycycline, the patient fully recovered without hip pain and with negative follow-up blood cultures.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Introduction

Case presentation

Authors contributions

Ethical approval statement

Declaration of Competing Interest

Author Manuscript Author Manuscript Author Manuscript Author Manuscript | | HHS Public Access
Author manuscript
J Infect Public Health. Author manuscript; available in PMC 2026 January 06. | | --- | --- | Published in final edited form as: J Infect Public Health. 2025 October ; 18(10): 102937. doi:10.1016/j.jiph.2025.102937 . Melioidosis presenting as septic arthritis in hip joint of a 60-year old patient: Findings from a hospital-based surveillance in Bangladesh Ayesha Jamal Anannaa, Lovely Baraib, Jamal Uddin Ahmedb, Jubaidul Islamb, Muhammad Abdur Rahimb, Tushar Kumar Dasa, Nurun Nahar Chistya, Saima Aktera, Jay E. Geec, Christopher A. Gulvikc, Caroline A. Schrodtc, Zachary P. Weinerc, Sukanta Chowdhurya,* a International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh bBangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh cBacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, United States Abstract Melioidosis is a fatal bacterial infection caused by a soil-borne bacterium Burkholderia pseudomallei. Pneumonia, localized abscess and acute septicemia are the most common clinical presentations for melioidosis. Septic arthritis is relatively uncommon clinical manifestation and may cause severe infection. Here, we report a melioidosis case of a 60-year old diabetic male presenting with fever and acute hip pain. B. pseudomallei was isolated from blood culture and it was sensitive to meropenem, amoxicillin-clavulanic acid, cotrimoxazole, ceftazidime and doxycycline. The genome sequence from the clinical isolate obtained from this patient clusters with other Bangladeshi strains and it is within the major clade of East and Southeast Asia strains. The patient received parental meropenem for four weeks followed by six months of oral cotrimoxazole and doxycycline. We followed up the patients every three months over the past seven months. After seven months of oral antibiotic therapy, the patient fully recovered without feeling pain in hip joint and no further complications. His blood culture was tested negative This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)). * [Corresponding author. sukanta@icddrb.org](Corresponding author. sukanta@icddrb.org) (S. Chowdhury) . Authors contributions A.J.A and S.C. participated in conceptualization and methodology. A.J.A., L.B, J.U.A, J.I, A.R, T.K.D, N.N.C, S.A, C.A.S and S.C worked on analysis, and A.J.A prepared the manuscripts. J.E.G, C.A.G and Z.P.W performed genome sequencing and interpreted results. C.A.S and S.C. contributed to the supervision of methodology, data analysis, and manuscript edition. A.J.A., L.B, J.U.A, J.I, A.R, T.K.D, N.N.C, S.A, C.A.S and S.C participated in manuscript edition. Ethical approval statement The melioidosis surveillance protocol was reviewed and approved by the Institutional Review Board of icddr,b (PR-20096) . The patient provided informed, written consent to participate in the study. Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This work was supported by CDC Emerging Infectious Disease funds. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Author Manuscript Author Manuscript Author Manuscript Author Manuscript Ananna et al. Page 2 after seven months. The findings ofthe case report are valuable for raising clinical suspicion and prompting laboratory testing to detect melioidosis. The report also detailed the disease progression and the response to antibi

FAQs

What clinical presentation does the report focus on for melioidosis?

The report focuses on a case where melioidosis presented as septic arthritis in the hip joint, along with fever and acute hip pain in a 60-year-old diabetic male.

How was Burkholderia pseudomallei identified and what was the antibiotic susceptibility?

Burkholderia pseudomallei was isolated from blood culture and was sensitive to meropenem, amoxicillin-clavulanic acid, cotrimoxazole, ceftazidime, and doxycycline.

What treatment regimen and outcome were reported?

The patient received parental meropenem for four weeks followed by six months of oral cotrimoxazole and doxycycline, with full recovery after seven months and no further complications; follow-up blood cultures tested negative.

Sep 29, 2026

Uploaded by McQueen