Septic arthritis of the knee due to Burkhoderia pseudomallei

A 65-year-old Chinese woman presented with a painful and swollen right knee since 3 weeks. Despite treatment with analgesics, there was progression of pain and swelling. The radiographs showed bony destruction with associated soft tissue swelling, suggestive of septic arthritis. Magnetic resonance imaging revealed a large knee joint effusion and pockets of abscesses in the surrounding muscles and subcutaneous tissue. There was associated osteomyelitis in the femoral condyle and upper tibia. The culture of pus revealed Burkhoderia pseudomallei. The patient improved after 9 months of treatment by antibiotics and repeated debridement. Septic arthritis of the knee joint caused by Melioidosis is a rare entity that requires a prompt diagnosis. Clinically, it may mimic infective and non-infective arthritis. Lack of awareness of this condition may lead to patient morbidity and even mortality.