Osteomyelitis and septic arthritis from infection with Burkholderia pseudomallei: A 20-year prospective melioidosis study from northern Australia

L MORSE, J L Smith, M Mehta, Linda Ward, Allen Cheng, Bart Currie

    Research output: Contribution to journalArticle

    Abstract

    Background: The gram-negative organism, Burkholderia pseudomallei, is responsible for the disease melioidosis. Septic arthritis and osteomyelitis due to B. pseudomallei are rare but recognised presentations of the disease.

    Methods: A prospective database of all cases of melioidosis in the Northern Territory of Australia has been kept since October 1989. Entries to April 2009 were reviewed and cases involving bone and/or joint were investigated. We also present in detail the case reports of 3 presentations of bone and joint melioidosis.

    Results: There were 536 presentations of melioidosis during the 20-year study period. Amongst these, there were 13 patients with primary septic arthritis and 7 cases of primary osteomyelitis. Septic arthritis and osteomyelitis were secondary to primary melioidosis elsewhere in 14 and 7 patients respectively. Melioidosis patients with bone/joint involvement were more likely to be Indigenous (p=0.006) and female (p=0.023) compared to patients with other presentations of disease.

    Conclusions: Timely microbiological diagnosis and prompt treatment of melioidosis involving bone and/or joint with appropriate intravenous antibiotics is important, as is adequate surgical drainage and debridement where indicated. A subsequent protracted course of antibiotic eradication therapy is important to avoid relapse of disease. � 2013 JPR Solutions. Published by Reed Elsevier India Pvt. Ltd.
    Original languageEnglish
    Pages (from-to)86-91
    Number of pages6
    JournalJournal of Orthopaedics
    Volume10
    Issue number2
    DOIs
    Publication statusPublished - 2013

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