Chronic Osteomyelitis of the Femur: A Rare Manifestation of Melioidosis.

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. While pulmonary and cutaneous manifestations are common, osteomyelitis is a relatively rare presentation. This case report describes a middle-aged man who presented with fever, fluctuating sensorium, and right knee pain for five months. Blood cultures grew B. pseudomallei, confirming the diagnosis of melioidosis. Imaging revealed osteomyelitis of the right femur as the primary clinical manifestation. The patient's altered sensorium was attributed to severe hyponatremia, a complication often associated with poor clinical outcomes in melioidosis. He was managed with culture-guided intravenous antibiotic therapy for two weeks, followed by oral eradication therapy for three months.