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She responded well with complete resolution of the submandibular and parotid abscesses after 4\u2009weeks of treatment. This case emphasises the importance of a high index of suspicion of melioidosis in endemic regions due to its diverse clinical presentation and diagnostic challenges.<\/jats:p>","DOI":"10.1136\/bcr-2025-266603","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T21:30:28Z","timestamp":1751405428000},"page":"e266603","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Clival osteomyelitis as a rare complication of paediatric melioidosis"],"prefix":"10.1136","volume":"18","author":[{"given":"Nicole Phing Jie","family":"Hoo","sequence":"first","affiliation":[{"name":"Paediatrics, Miri Hospital, Miri, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sin Toun","family":"Loh","sequence":"additional","affiliation":[{"name":"Paediatrics, Miri Hospital, Miri, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Li","family":"Lo","sequence":"additional","affiliation":[{"name":"Paediatrics, Miri Hospital, Miri, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9665-3054","authenticated-orcid":false,"given":"David Chun-Ern","family":"Ng","sequence":"additional","affiliation":[{"name":"Paediatrics, Hospital Tuanku Ja\u2019afar Seremban, Seremban, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082722583252000_18.7.e266603.1","DOI":"10.1128\/JCM.44.1.85-90.2006"},{"key":"2025082722583252000_18.7.e266603.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005650","article-title":"Pediatric melioidosis in Sarawak, Malaysia: Epidemiological, clinical and microbiological characteristics","volume":"11","author":"Mohan","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"2025082722583252000_18.7.e266603.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-020-4937-8","article-title":"Disseminated melioidosis in early pregnancy - an unproven cause of foetal loss","volume":"20","author":"Chang","year":"2020","journal-title":"BMC Infect Dis"},{"doi-asserted-by":"publisher","key":"2025082722583252000_18.7.e266603.4","DOI":"10.1093\/cid\/civ189"},{"key":"2025082722583252000_18.7.e266603.5","first-page":"174","article-title":"Cases of melioidosis in a university teaching hospital in Malaysia","volume":"41","author":"Raja","year":"2008","journal-title":"J Microbiol Immunol Infect"},{"key":"2025082722583252000_18.7.e266603.6","doi-asserted-by":"crossref","DOI":"10.3390\/tropicalmed3010025","article-title":"Melioidosis in Malaysia: Incidence, Clinical Challenges, and Advances in Understanding Pathogenesis","volume":"3","author":"Nathan","year":"2018","journal-title":"Trop Med Infect Dis"},{"key":"2025082722583252000_18.7.e266603.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012317","article-title":"Bone and joint infections due to melioidosis; 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