Background: Melioidosis is a life-threatening infection endemic in the Northern Territory. Even a delayed diagnosis contributes to significant morbidity in both adults and children. ENT presentations are uncommon and tend to resemble routine bacterial infections, increasing the risk of missed or late diagnosis. This poster presentation aims to summaries the latest information on melioidosis as well as provide a clear visual aid to facilitate early recognition of melioid tissue. Aims: To emphasise the importance of early identification of melioidosis in ENT presentations with a summary of the prevalence, pathogenesis, diagnosis, treatment and prognosis. Methods: We present the case of a child found to have melioid mastoiditis. Results: The clinical picture initially consistent with standard bacterial disease was soon accurately diagnosed as melioidosis. This case allows for a recap on melioidosis as well as a clear visual representation of the key findings crucial for early diagnosis and improved clinical outcomes in endemic and rural regions. Conclusion: In the Northern Territory, ENT clinicians should maintain a high index of suspicion for melioidosis, particularly when encountering creamy, finely granular tissue in mastoid or deep-neck infections. This case reinforces the value of recognising these characteristic features to facilitate early testing and treatment, ultimately improving patient outcomes.