The Hidden Threat: Polyarticular Septic Arthritis Unmasking Disseminated Melioidosis

Melioidosis is an infection caused by Burkholderia Pseudomallei, endemic to South East Asia and Northern Australia but rarely seen in the Indian subcontinent. Melioidosis causing polyarticular septic arthritis is an extremely rare entity. It must be kept as a differential diagnosis in endemic regions to provide early diagnosis and timely management to improve patient outcome.

Here, we present the case of a 31-year-old man who presented with fever, abdominal, and significant weight loss since 2 months. He has long-standing diabetes mellitus and chronic alcohol abuse. He developed right elbow pain with painful range of motion 1 week into his hospital stay and was taken up for arthrotomy. One week post this, he developed right knee pain and restriction of movement. A positive synovial tissue histopathology examination showed B. pseudomallei. He achieved symptomatic improvement and disease control under ongoing eradication therapy.

This case throws light on a possibility of polyarticular septic arthritis caused by disseminated melioidosis. A rare but significant entity in endemic regions . While keeping melioidosis as a differential, early diagnosis and prompt treatment can provide favorable short-term outcome, though risk of relapse remains given ongoing therapy and limited follow-up.