MELIOIDOTIC OSTEOMYELITIS IN NORTHERN AUSTRALIA

Background: Osteomyelitis is a well-recognized manifestation of melioi dosis, a significant disease that is endemic in South-East Asia and no rthern Australia. Diagnosis requires a high degree of clinical suspici on and is dependent on microbiological confirmation; important clues a re travel to or residence in an endemic area. Infection often but not always occurs in well-recognized risk groups, especially diabetics and alcoholics. Subacute presentations often mimic other disease processe s and patients may not always be clinically septic. Treatment requires surgical drainage in combination with multiple antibiotic therapy, in cluding at least 2 weeks of intravenous ceftazidime and oral therapy c ontinuing for 3-6 months. Non-compliance usually results in relapse, D ue to the potential long latency of the disease and the possibility of reactivation, follow-up should probably be life-long. Methods: A pros pective study of 115 patients presenting with melioidosis between 1989 and 1995 was undertaken. Results: Four patients were found to have os teomyelitis. Conclusion: it is Important to be aware of this condition so that early treatment can be initiated.