{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T01:53:22Z","timestamp":1771725202129,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,25]]},"abstract":"<jats:p>Melioidosis, a syndrome with protean clinical manifestations, is caused by Gram-negative soil saprophyte <jats:italic>Burkholderiapseudomallei<\/jats:italic>. Among its diverse clinical presentations, the involvement of spine is a rare phenomenon and can mimic tuberculosis on presentation. A 65-year-old female with a known case of diabetes presented with fever with lower back pain. Blood culture grew <jats:italic>Staphylococcus aureus<\/jats:italic>, and as per sensitivity report, clindamycin and cefazolin were started. X-ray and MRI lumbosacral spine showed spondylodiscitis (likely Koch\u2019s). Decompression and biopsy were done, and a sample was sent for microbiological investigations that showed no growth of any significant pathogen; furthermore, all tests for tuberculosis diagnosis also remained negative. Active Melioidosis Detect Lateral Flow Assay was used on the tissue sample, which was positive for <jats:italic>B. pseudomallei<\/jats:italic> Capsular Polysaccharide (CPS) antigen; the case was confirmed by typethree secretion system 1 PCR for melioidosis. Antibiotics were changed to parenteral ceftazidime for 2 weeks followed by oral cotrimoxazole. A dedicated team of microbiologists and physicians is required to identify and treat the disease.<\/jats:p>","DOI":"10.1136\/bcr-2017-223223","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T07:20:22Z","timestamp":1518074422000},"page":"bcr-2017-223223","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Melioidosis: the great mimicker presenting as spondylodiscitis"],"prefix":"10.1136","volume":"2018","author":[{"given":"Rahul","family":"Garg","sequence":"first","affiliation":[{"name":"Kasturba Medical College Manipal, Manipal University, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tushar","family":"Shaw","sequence":"additional","affiliation":[{"name":"Kasturba Medical College Manipal, Manipal University, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9545-4838","authenticated-orcid":false,"given":"Shyamasunder N","family":"Bhat","sequence":"additional","affiliation":[{"name":"Kasturba Medical College Manipal, Manipal University, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiranjay","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"Kasturba Medical College Manipal, Manipal University, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,8]]},"reference":[{"key":"2025082803095162000_2018.feb07_2.bcr-2017-223223.1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.18.2.383-416.2005"},{"key":"2025082803095162000_2018.feb07_2.bcr-2017-223223.2","doi-asserted-by":"crossref","unstructured":"Limmathurotsakul D , Golding N , Dance DA , et al . 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