Melioidosis Unmasked—The Radiologic Chameleon with Multiorgan Faces: A Case Series of Multisystem Radiologic Presentations of the Great Mimicker

Melioidosis, caused by Burkholderia pseudomallei, is an emerging infectious disease endemic to Southeast Asia and parts of India. It often mimics tuberculosis, malignancies, and other pyogenic infections and is known for its diverse clinical and radiologic presentations, making diagnosis challenging. This case series presents five culture-confirmed cases of melioidosis, each involving distinct organ systems: Vascular, genitourinary, central nervous, musculoskeletal, and spinal. All patients had predisposing risk factors like diabetes, chronic kidney or liver disease, or steroid use. Imaging modalities, including CT, MRI, and ultrasound, were pivotal in detecting multisystem involvement and guiding management. Uncommon but critical manifestations such as mycotic aortic aneurysm, prostate abscess, neuromelioidosis, and spinal epidural abscess are highlighted. This series emphasizes the role of radiologists in identifying the varied imaging patterns of melioidosis and reinforces the need for heightened clinical suspicion, particularly in endemic regions. Early radiologic recognition is vital for timely culture confirmation and appropriate treatment.