title: Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent.
abstract: BACKGROUND
  Melioidosis involving bone, joints, and soft tissue is rare and reported usually following dissemination of disease from infection elsewhere in the body; to a lesser degree, it can also be reported as the primary manifestation of melioidosis.
  
  
  METHODS
  The orthopedic registry at Hospital University Sains Malaysia from 2008 until 2014 was retrospectively reviewed and was followed by molecular typing of Burkholderia pseudomallei.
  
  
  RESULTS
  Out of 20 cases identified, 19 patients were confirmed to have osteoarticular and/or soft-tissue melioidosis. The majority of the patients were males (84%), and 16 patients had underlying diabetes mellitus with no significant estimated risk with the disease outcomes. Bacterial genotype was not associated with the disease as a risk. Death was a significant outcome in patients with bacteremic infections (p = 0.044).
  
  
  CONCLUSIONS
  Patients with lung or skin melioidosis require careful treatment follow-up to minimize the chance for secondary osteoarticular infection. Human risk factors remain the leading predisposing factors for melioidosis. Early laboratory and clinical diagnosis and acute-phase treatment can decrease morbidity and mortality.
authors.affiliation: School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. zeuterabdelrahman@gmail.com.
authors.forename: AbdelRahman Mohammad
authors.initials: AM
authors.lastname: Zueter
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abumarzouq
authors.forename: Mohd Imran
authors.initials: MI
authors.lastname: Yusof
authors.forename: Wan Faisham
authors.initials: WF
authors.lastname: Wan Ismail
authors.forename: Azian
authors.initials: A
authors.lastname: Harun
mesh_terms: D000293:Adolescent; D000328:Adult; D016957:Burkholderia pseudomallei / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D002648:Child; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008554:Melioidosis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D008875:Middle Aged; D058889:Molecular Typing; D010003:Osteoarthritis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D016019:Survival Analysis; D055815:Young Adult