Melioidosis: a rare but not forgotten cause of fever of unknown origin.

Melioidosis is widely prevalent in Southeast Asia and northern Australia. Although it is believed to pose no current threat to the populations of developed countries, the increased mobility of people around the world and of Southeast Asian refugees to Western countries may change this. Its long incubation period may put a relatively large number of currently asymptomatic people at risk. It should be considered in the differential diagnosis of any febrile illness in a person who has visited an endemic area, especially if the presenting features are those of fulminant respiratory failure, if multiple pustular or necrotic skin or subcutaneous lesions develop, or if there is a radiologic pattern of tuberculosis from which tubercle bacilli cannot be demonstrated.