Multifocal melioidosis with femoral osteomyelitis in a healthy 25-year-old traveller.

To cite: Conrad A, Valour F, Ferry T, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016216356 DESCRIPTION A 25-year-old woman presented with a 3-week history of fever and weight loss on return from a trip to Thailand. Clinical examination revealed inflammatory tumefaction of the right knee and of the right wrist. Positive blood cultures identified Burkholderia pseudomallei. MRI confirmed right palmar tenosynovitis and osteoarthritis of the carpus (figure 1A, B) as well as osteomyelitis of the right femur’s lower extremity (figure 1C, D). In addition, a positron emission tomography CT (PET-CT) scan (figure 1E) showed multifocal melioidosis involving the liver, lung, lymph nodes and multiple cutaneous and muscular nodules.