In summary, we present a case of melioidosis that amply demonstrates its ability to cause severe illness, often in patients with pre-existing renal problems, and its propensity to cause further severe derangement in renal function. Usually this is in the form of oliguric acute renal failure presumably caused, in the main, by acute tubular necrosis. However, the case we present indicates that, in common with certain other specific infectious diseases, nephrotic syndrome may be a significant (albeit rare) complication of infection with B. pseudomallei. We postulate that immune-complex mediated renal injury may occur in melioidosis.