The central nervous system (CNS) melioidosis is uncommon. The authors report a case of melioidosis brain abscess who presented with a 5-month history of seizures and right leg weakness. The presentation, neuroimages, and pathology mimicked tuberculous granuloma or abscess. The diagnosis was finally made by the culture of subdural tissue. The authors advise that the CNS melioidosis should be suspected if a patient presenting with CNS granuloma or abscess lives in the endemic area of melioidosis and has any of its risk factors. Prompt diagnosis and treatment remain crucial due to its high mortality rate.

Keywords: Central nervous system, Neurological, Melioidosis