In areas where melioidosis is endemic, stress on the healthcare system is substantial. Because clinical manifestations are protean, the illness is difficult to diagnose, and cutaneous Burkholderia pseudomallei infections can progress to necrotizing fasciitis. While it is and uncommon complication of cutaneous melioidosis, necrotizing fasciitis is potentially fatal and requires aggressive management, including early diagnosis, appropriate antibiotics selection and operative débridement.