E-ISSN 2146-9369 | ISSN 2146-3158
 

Case Report


Case series of calcaneal osteomyelitis in patients with melioidosis

Karthik Babu Raj, Neeraj Kotteppattu Chandran, Manojan Thekkedath.


Abstract
Background:
Melioidosis is an emerging infectious disease caused by the Gram-negative bacterium Burkholderia pseudomallei, which can lead to a range of clinical manifestations including acute septicaemia and chronic localized infections. Osteomyelitis is an uncommon but well-recognized complication of melioidosis, with the calcaneus being a relatively rare site of involvement.
Case Description:
The authors present a case series of three patients with calcaneal osteomyelitis caused by B. pseudomallei infection. All three patients presented with non-specific symptoms like fever and weight loss, followed by localized ankle/foot pain and swelling. Diagnosis was made based on imaging findings (radiographs and MRI) and isolation of Burkholderia pseudomallei from blood or pus cultures. Treatment involved a combination of initial intravenous antibiotic therapy (meropenem or ceftazidime) for 4-6 weeks, followed by oral trimethoprim-sulfamethoxazole for 6 months. One patient required surgical drainage of a plantar abscess. All patients had a favourable clinical outcome with resolution of osteomyelitis on follow-up imaging.
Conclusion:
Calcaneal osteomyelitis is a rare but potentially serious complication of melioidosis. Early recognition and prompt initiation of appropriate antibiotic therapy are crucial for favourable outcomes. Clinicians should maintain a high index of suspicion for osteomyelitis in patients with melioidosis, especially in patients from endemic areas as well as in patients with risk factors like diabetes. Close follow-up and monitoring for potential relapse or reactivation are essential, particularly in immunocompromised individuals.

Key words: Melioidosis, Burkholderia pseudomallei, Osteomyelitis, Calcaneal, Case series


 
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How to Cite this Article
Pubmed Style

Raj KB, Chandran NK, Thekkedath M. Case series of calcaneal osteomyelitis in patients with melioidosis. J Microbiol Infect Dis. 2024; 14(2): 88-92. doi:10.5455/JMID.2024.v14.i2.7


Web Style

Raj KB, Chandran NK, Thekkedath M. Case series of calcaneal osteomyelitis in patients with melioidosis. https://www.jmidonline.org/?mno=194292 [Access: October 12, 2024]. doi:10.5455/JMID.2024.v14.i2.7


AMA (American Medical Association) Style

Raj KB, Chandran NK, Thekkedath M. Case series of calcaneal osteomyelitis in patients with melioidosis. J Microbiol Infect Dis. 2024; 14(2): 88-92. doi:10.5455/JMID.2024.v14.i2.7



Vancouver/ICMJE Style

Raj KB, Chandran NK, Thekkedath M. Case series of calcaneal osteomyelitis in patients with melioidosis. J Microbiol Infect Dis. (2024), [cited October 12, 2024]; 14(2): 88-92. doi:10.5455/JMID.2024.v14.i2.7



Harvard Style

Raj, K. B., Chandran, . N. K. & Thekkedath, . M. (2024) Case series of calcaneal osteomyelitis in patients with melioidosis. J Microbiol Infect Dis, 14 (2), 88-92. doi:10.5455/JMID.2024.v14.i2.7



Turabian Style

Raj, Karthik Babu, Neeraj Kotteppattu Chandran, and Manojan Thekkedath. 2024. Case series of calcaneal osteomyelitis in patients with melioidosis. Journal of Microbiology and Infectious Diseases, 14 (2), 88-92. doi:10.5455/JMID.2024.v14.i2.7



Chicago Style

Raj, Karthik Babu, Neeraj Kotteppattu Chandran, and Manojan Thekkedath. "Case series of calcaneal osteomyelitis in patients with melioidosis." Journal of Microbiology and Infectious Diseases 14 (2024), 88-92. doi:10.5455/JMID.2024.v14.i2.7



MLA (The Modern Language Association) Style

Raj, Karthik Babu, Neeraj Kotteppattu Chandran, and Manojan Thekkedath. "Case series of calcaneal osteomyelitis in patients with melioidosis." Journal of Microbiology and Infectious Diseases 14.2 (2024), 88-92. Print. doi:10.5455/JMID.2024.v14.i2.7



APA (American Psychological Association) Style

Raj, K. B., Chandran, . N. K. & Thekkedath, . M. (2024) Case series of calcaneal osteomyelitis in patients with melioidosis. Journal of Microbiology and Infectious Diseases, 14 (2), 88-92. doi:10.5455/JMID.2024.v14.i2.7