Chronic Osteomyelitis of the Femur: A Rare Manifestation of Melioidosis

Melioidosis is an infectious disease caused by <i>Burkholderia pseudomallei</i>. 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 <i>B. pseudomallei</i>, 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.