ArticlePLoS neglected tropical diseases2024
Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes.
Article in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Global research trends, knowledge structure, and future directions in melioidosis research: a bibliometric analysis, 1990-2025.Tropical medicine and health · 2026Article
- Synovial Fluid Analysis in Melioidosis: Experiences from the Darwin Prospective Melioidosis Study.Pathogens (Basel, Switzerland) · 2025Article
- Epidemiological and Clinical Manifestations of Acute Rheumatic Fever in Far North Queensland, Australia.Pathogens (Basel, Switzerland) · 2025Article
- Osteomyelitis and Septic Arthritis in the Darwin Prospective Melioidosis Study.Open forum infectious diseases · 2025Article
- The Association Between Statin Therapy and the Subsequent Clinical Course of Patients With Melioidosis.Journal of tropical medicine · 2025Article
- The characteristics and clinical course of patients with melioidosis and cancer.PLoS neglected tropical diseases · 2024Article
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8 authors.
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Abstract
backgroundMelioidosis, a life-threatening infection caused by the gram negative bacterium Burkholderia pseudomallei, can involve almost any organ. Bone and joint infections (BJI) are a recognised, but incompletely defined, manifestation of melioidosis that are associated with significant morbidity and mortality in resource-limited settings. METHODOLOGY/PRINCIPAL
findingsWe identified all individuals with BJI due to B. pseudomallei managed at Cairns Hospital in tropical Australia between January 1998 and June 2023. The patients' demographics, their clinical findings and their treatment were correlated with their subsequent course. Of 477 culture-confirmed cases of melioidosis managed at the hospital during the study period, 39 (8%) had confirmed BJI; predisposing risk factors for melioidosis were present in 37/39 (95%). However, in multivariable analysis only diabetes mellitus was independently associated with the presence of BJI (odds ratio (95% confidence interval): 4.04 (1.81-9.00), p = 0.001). BJI was frequently only one component of multi-organ involvement: 29/39 (74%) had infection involving other organs and bacteraemia was present in 31/39 (79%). Of the 39 individuals with BJI, 14 (36%) had osteomyelitis, 8 (20%) had septic arthritis and 17 (44%) had both osteomyelitis and septic arthritis; in 32/39 (83%) the lower limb was involved. Surgery was performed in 30/39 (77%). Readmission after the initial hospitalisation was necessary in 11/39 (28%), 5/39 (13%) had disease recrudescence and 3/39 (8%) had relapse; 4/39 (10%) developed pathological fractures. ICU admission was necessary in 11/39 (28%) but all 11 of these patients survived. Only 1/39 (3%) died, 138 days after admission, due to his significant underlying comorbidity.
conclusionsThe case-fatality rate from melioidosis BJI in Australia's well-resourced health system is very low. However, recrudescence, relapse and orthopaedic complications are relatively common and emphasise the importance of collaborative multidisciplinary care that includes early surgical review, aggressive source control, prolonged antibiotic therapy, and thorough, extended follow-up.
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