{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:41:15Z","timestamp":1791186075969,"version":"4.1.0"},"reference-count":18,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T00:00:00Z","timestamp":1532995200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/deed.en_GB"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7,31]]},"abstract":"Summary<\/jats:title>\n \n Diabetes mellitus is a well-recognised risk factor for melioidosis, the disease caused by\n Burkholderia pseudomallei<\/jats:italic>\n , which is endemic in northern Australia and Southeast Asia. We present the initial diagnostic dilemma of a febrile patient from northern Australia with type 1 diabetes mellitus and negative blood cultures. After a 6-week history of fevers and undifferentiated abdominal pain, MRI of her spine revealed a psoas abscess. She underwent drainage of the abscess which cultured\n B. pseudomallei.<\/jats:italic>\n She completed 6 weeks of intravenous (IV) ceftazidime and oral trimethoprim\/sulphamethoxazole (TMP\/SMX) followed by a 12-week course of oral TMP\/SMX. We postulate that the likely route of infection was inoculation via her skin, the integrity of which was compromised from her insulin pump insertion sites and an underlying dermatological condition.\n <\/jats:p>\n \n Learning points:<\/jats:title>\n \n \n Diabetes mellitus is the strongest risk factor for developing melioidosis.<\/jats:p>\n <\/jats:list-item>\n \n Atypical infections need to be considered in individuals with diabetes mellitus who are febrile, even if blood cultures are negative.<\/jats:p>\n <\/jats:list-item>\n \n There is heterogeneity in the clinical presentation of melioidosis due to variable organ involvement.<\/jats:p>\n <\/jats:list-item>\n \n Consider melioidosis in febrile patients who have travelled to northern Australia, Asia and other endemic areas.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Conway","sequence":"additional","affiliation":[{"name":"1Department of Diabetes and Endocrinology, Cairns Hospital, Cairns, Queensland, Australia"},{"name":"3School of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashim","family":"Sinha","sequence":"additional","affiliation":[{"name":"1Department of Diabetes and Endocrinology, Cairns Hospital, Cairns, Queensland, Australia"},{"name":"3School of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"ref101","doi-asserted-by":"crossref","first-page":"e900","DOI":"10.1371\/journal.pntd.0000900","article-title":"The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective 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