Chronic multifocal osteomyelitis: A rare presentation of melioidosis

A 45-year-old gentleman presented with fever, weight loss, and painful swelling of both knees. His history was significant for type 2 diabetes mellitus. Blood cultures grew Burkholderia pseudomallei, and imaging revealed osteomyelitis of bilateral distal femura and proximal tibiae, with no involvement of the joint space. He underwent debridement and was initiated on ceftazidime followed by eradication therapy with trimethoprim–sulfamethoxazole. He recovered well with no further complications. Melioidosis is a rare cause of multifocal osteomyelitis and is a differential to be considered in an appropriate clinicoepidemiological setting.