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Melioidosis — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesMelioidosisRACP Adult Medicine

A 42-year-old farmer in Far North Queensland presents with a 10-day history of fever, productive cough, and a CXR showing upper-lobe pneumonia with cavitation. Blood cultures grow Burkholderia pseudomallei. He has poorly controlled diabetes. What is the most likely diagnosis?

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Correct answer: A — Melioidosis

Melioidosis (caused by B. pseudomallei) is endemic in tropical Australia, particularly the Top End and FNQ. Diabetes is the major risk factor. It presents with pneumonia (often upper-lobe cavitating), septicaemia, or abscess formation. Treatment is intensive phase IV meropenem for ≥2 weeks followed by oral TMP-SMX eradication for ≥3 months.

Reference: eTG Antibiotic – 2025 – Melioidosis; Darwin Melioidosis Guidelines 2024