Melioidosis is an infectious disease caused by gram negative bacterium Burkholderia pseudomallei. It is a soil and water pathogen and transmitted to humans through inoculation or inhalation. This disease is considered endemic in India and largely remains under reported. The most common presentation is pneumonia and bacteraemia, which can present acutely and as septic shock. Chronic presentation include-abscess, septic arthritis, osteomyelitis. The major risk factors are diabetes, liver disease, renal disease, chronic lung disease. In this article 18 cases have been reviewed; their clinical features, treatment and outcome are discussed. This is to highlight the varied presentations, high degree of clinical suspicion needed to suspect and start empiric therapy, good microbiological support to arrive at right diagnosis and timely treatment of this infection as it carries high mortality, if left untreated. Also, this is the largest reported case series from Kerala till date.
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