The time taken for Burkholderia pseudomallei to develop the clinical onset after exposure is highly variable and it is very hard to define. A prospective study shows that the incubation period range from 1-21 days (average 9 days) in 25 % of cases who had the percutaneous exposure to the soil during the monsoon (Currie et al., 2000).

The disease can be seen as bacterial pneumonia, septicaemia, acute localized infection of skin and soft tissues following trauma, inoculation, chronic infection or even acute cholangitis. The organism usually spreads by direct skin contact, through ingestion or inhalation with contaminated source. (Suputtamongkol et al., 1994).

An acute septicaemic infection is the most severe form of active infection and it has high mortality rate. Melioidosis presents with pyrexia of unknown origin (PUO) or visceral abscesses, or septic arthritis (Jesudason et al., 2003). Histopathologically, the disease is characterized by abscess formation in a variety of organs and associated with necrotizing fasciitis, sepsis. Cutaneous abcesses may be localized to skin or it may be result from bacteremic spread to the skin (Mickail et al., 2012). The localized cutaneous abscesses occur without systemic infection occasionally. A case report of isolated cutaneous melioidosis breast abscesses in a young adult suggests that melioidosis may be a more common cause of cutaneous abscesses in Western Hemisphere (Teo et al., 2006). The polyarteritis nodosa, severe skin pustules with sepsis and extensive ecthyme-like lesions with disseminated melioidosis are the cutaneous manifestations of melioidosis. Leukocytosis, lymphopenia and hypoalbuminemia can be the markers of severity of this type of infection (Gibney et al., 2008).

In case of neurological melioidosis, the most prominent feature include unilateral limb weakness, cerebellar ataxia and paraparesis (Currie et al., 2000) where as acute pulmonary melioidosis is characterized by high fever and pulmonary distress which is followed by the appearance of abscesses and death occur within a few days if the patient is untreated (Jansen et al., 2005).