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Disseminated Melioidosis from a Ruptured Infective Aortic Aneurysm and Pedal Ulcers to Septic Arthritis and

Jithin Jagan Sebastian1, Bricilla Gnana Preethe1, Sairam Subramanian1

  • 1Department of Vascular and Endovascular Surgery, SRM Institutes for Medical Science, Chennai, India.

Vascular Specialist International
|August 14, 2025
PubMed

Insights

Burkholderia pseudomallei can cause severe melioidosis with rare presentations. Early diagnosis and appropriate antibiotic treatment are crucial for managing disseminated infections and improving patient outcomes.

Area of Science:

  • Infectious Diseases
  • Bacteriology
  • Medical Imaging

Background:

  • Melioidosis, caused by Burkholderia pseudomallei (BP), can present with disseminated disease and rare clinical manifestations.
  • Prompt diagnosis and effective treatment are essential for managing severe BP infections.

Observation:

  • A 65-year-old male presented with fever, back pain, and infected pedal ulcers, later found to have an abdominal aortic aneurysm.
  • Blood cultures identified BP, sensitive to cephalosporins and carbapenems. Despite surgical repair, the patient developed disseminated disease, including osteomyelitis and septic arthritis.

Findings:

  • Positron emission tomography-computed tomography (PET-CT) was instrumental in diagnosing widespread dissemination of BP infection.
  • Initial diagnosis of melioidosis was delayed due to routine cultures not speciation BP.

Implications:

  • PET-CT aids in diagnosing disseminated melioidosis, especially in complex cases.
  • Delayed diagnosis and perioperative complications can increase mortality in melioidosis patients.
  • This case highlights the importance of considering BP in endemic areas and utilizing advanced imaging for diagnosis.
Keywords:
ArthritisInfective aneurysmMelioidosisOsteomyelitisSepsis

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