BACKGROUND Melioidosis is considered endemic in certain areas of the world. Musculoskeletal and soft tissue involvement are relatively uncommon presentations in melioidosis. We present a case of infective myositis in a patient with melioidosis in Sri Lanka, which is not considered an endemic country. Even though multiple cases of melioidosis have been reported with an increasing number in Sri Lanka, infective myositis secondary to melioidosis was not reported previously. CASE PRESENTATION A 60-year-old Sinhalese man with diabetes presented with fever of 4 months' duration and a limp with a painful lump on the right side of the upper thigh of 2 months' duration. He had been treated in a local hospital for community-acquired pneumonia 3 weeks prior to this admission, for which he had received intravenous meropenem and teicoplanin with intensive care unit admission. He had a 0.5-cm × 0.5-cm tender lump over the right vastus lateralis muscle, and contrast-enhanced computed tomography of the area showed an ill-defined, heterogeneously enhancing, hypodense area involving the vastus lateralis, vastus intermedius, and quadratus femoris, suggestive of infective myositis but without abscess formation. Histopathology of the muscle biopsied from the vastus lateralis showed suppurative inflammation of subcutaneous fat with connective tissue necrosis and muscle infiltrated by lymphocytes. These features are suggestive of infective myositis possibly due to melioidosis. Although the result of a culture taken from the muscle biopsy was negative, the patient's antibody titer was strongly positive for melioidosis. He did not show any other areas with infected foci. He was treated with intravenous meropenem for 2 weeks and responded well. He was discharged with trimethoprim-sulfamethoxazole for 6 months as a maintenance therapy. CONCLUSION Melioidosis is commonly an undiagnosed disease that has a wide variety of clinical presentations. Myositis in melioidosis is uncommon, and careful evaluation is mandatory to avoid misdiagnosis of this treatable but fatal disease. The clinician should have a high index of clinical suspicion, and further clinical and epidemiological studies are needed to determine the true burden of the disease.

中文翻译：

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感染性肌炎，一种不常见的类li虫病表现：一例病例报告和文献复习。

背景技术在世界上某些地区，类胡Mel病被认为是地方性的。肌肉骨骼和软组织受累是类鼻oid病相对罕见的表现。我们介绍了斯里兰卡的一个类me虫病患者感染性肌炎的病例，这不被认为是一个流行国家。尽管斯里兰卡报告了多例类胡萝卜素病例，但数量有所增加，但先前并未报告过继发于类胡萝卜素的感染性肌炎。病例介绍一名60岁的Sinhalese糖尿病男子，发烧持续4个月，mp软，大腿右侧持续2个月疼痛。入院前3周，他曾在当地医院因社区获得性肺炎接受治疗，为此，他接受了重症监护病房的静脉注射美罗培南和替考拉宁治疗。他在右侧股外侧肌上有一个0.5厘米×0.5厘米的嫩块，并且该区域的对比增强计算机断层扫描显示出一个模糊不清，异质增强的低密度区域，涉及股外侧股骨，中间股间肌和股四头肌提示感染性肌炎，但无脓肿形成。从股外侧肌活检的肌肉的组织病理学表明，皮下脂肪的化脓性炎症伴结缔组织坏死，并且肌肉被淋巴细胞浸润。这些特征提示可能由于类鼻li病而引起的感染性肌炎。尽管从肌肉活检获得的培养结果是阴性的，但患者的抗体滴度却很强。他没有显示出有其他病灶被感染的区域。他接受美罗培南静脉注射治疗2周，反应良好。他接受了甲氧苄氨嘧啶磺胺甲基异恶唑的治疗，为期6个月。结论类痔病通常是一种未经诊断的疾病，具有多种临床表现。类风湿病中的肌炎并不常见，必须进行认真评估，以免误诊这种可治疗但致命的疾病。临床医生应具有较高的临床怀疑指数，并且需要进一步的临床和流行病学研究来确定疾病的真正负担。结论类痔病通常是一种未经诊断的疾病，具有多种临床表现。类风湿病中的肌炎并不常见，必须进行认真评估，以免误诊这种可治疗但致命的疾病。临床医生应具有较高的临床怀疑指数，并且需要进一步的临床和流行病学研究来确定疾病的真正负担。结论类痔病通常是一种未经诊断的疾病，具有多种临床表现。类风湿病中的肌炎并不常见，必须进行认真评估，以免误诊这种可治疗但致命的疾病。临床医生应具有较高的临床怀疑指数，并且需要进一步的临床和流行病学研究来确定疾病的真正负担。