Two-Stage Revision Total Knee Arthroplasty for Melioidosis Prosthetic Joint Infection

Case: Burkholderia pseudomallei can kill up to 40% of individuals who develop symptoms, but the pathogen has rarely been reported as a cause of prosthetic joint infection (PJI). We report a case of a woman with cultured-confirmed B. pseudomallei knee PJI who survived her infection and had excellent functional recovery after a 2-stage revision, 8 weeks of intravenous ceftazidime followed by 6 months of oral trimethoprim-sulfamethoxazole. Eight years later, she had no postoperative complications, no relapse, and an Oxford Knee Score of 34. Conclusion: B. pseudomallei PJI is rare but life-threatening. Two-stage revision and long-term antibiotic therapy are recommended to effect cure.