Melioidosis is an infectious disease caused by a bacteria called
Melioidosis, also called Whitmores disease, is an infectious disease
caused by the bacterium Burkholderia pseudomallei. Melioidosis is
clinically and pathologically similar to glanders disease, but the
ecology and epidemiology of melioidosis are different from glanders.
Melioidosis is predominately a disease of tropical climates, especially
in Southeast Asia where it is endemic. The bacteria causing melioidosis
are found in contaminated water and soil and are spread to humans and
animals through direct contact with the contaminated source. Glanders is
contracted by humans from infected domestic animals.
does melioidosis occur?
Melioidosis is most frequently reported in Southeast Asia and Northern
Australia. The bacteria that causes the disease is found in the soil,
rice paddies, and stagnant waters of the area. People get the disease by
inhaling dust contaminated by the bacteria and when the contaminated
soil comes in contact with abraded (scaped) area of the skin.
Melioidosis is endemic in
Southeast Asia, with the greatest concentration of cases reported in
Vietnam, Cambodia, Laos, Thailand, Malaysia, Myanmar (Burma), and
northern Australia. Additionally, it is seen in the South Pacific,
Africa, India, and the Middle East. In many of these countries, Burkholderia
pseudomallei is so prevalent that it is a common contaminate found
on laboratory cultures. Moreover, it has been a common pathogen isolated
from troops of all nationalities that have served in areas with endemic
disease. A few isolated cases of melioidosis have occurred in the
Western Hemisphere in Mexico, Panama, Ecuador, Haiti, Brazil, Peru,
Guyana, and in the states of Hawaii and Georgia. In the United States,
confirmed cases range from none to five each year and occur among
travelers and immigrants.
is melioidosis transmitted and who can get it?
Besides humans, many animal species are
susceptible to melioidosis. These include sheep, goats, horses, swine, cattle,
dogs, and cats. Transmission occurs by direct contact with contaminated soil and
surface waters. In Southeast Asia, the organism has been repeatedly isolated
from agriculture fields, with infection occurring primarily during the rainy
season. Humans and animals are believed to acquire the infection by inhalation
of dust, ingestion of contaminated water, and contact with contaminated soil
especially through skin abrasions, and for military troops, by contamination of
war wounds. Person-to-person transmission can occur. There is one report of
transmission to a sister with diabetes who was the caretaker for her brother who
had chronic melioidosis. Two cases of sexual transmission have been reported.
Transmission in both cases was preceded by a clinical history of chronic
prostatitis in the source patient
melioidosis affect a patient?
Melioidosis most commonly involves the lungs where the infection can
form a cavity of pus (abscess). It can spread from the skin through the
blood to affect the heart, brain, liver, kidneys, joints, and eyes.
Patients can have associated headaches, fever, chills, cough, chest
pain, and/or loss of appetite.
are the symptoms of melioidosis?
Illness from melioidosis can be
categorized as acute or localized infection, acute pulmonary infection, acute
bloodstream infection, and chronic suppurative infection. Inapparent infections
are also possible. The incubation period (time between exposure and appearance
of clinical symptoms) is not clearly defined, but may range from 2 days to many
infection: This form of infection is generally localized as a nodule
and results from inoculation through a break in the skin. The acute form of
melioidosis can produce fever and general muscle aches, and may progress rapidly
to infect the bloodstream.
infection: This form of the disease can produce a clinical picture of
mild bronchitis to severe pneumonia. The onset of pulmonary melioidosis is
typically accompanied by a high fever, headache, anorexia, and general muscle
soreness. Chest pain is common, but a nonproductive or productive cough with
normal sputum is the hallmark of this form of melioidosis.
bloodstream infection: Patients with underlying illness such as HIV,
renal failure, and diabetes are affected by this type of the disease, which
usually results in septic shock. The symptoms of the bloodstream infection vary
depending on the site of original infection, but they generally include
respiratory distress, severe headache, fever, diarrhea, development of
pus-filled lesions on the skin, muscle tenderness, and disorientation. This is
typically an infection of short duration, and abscesses will be found throughout
suppurative infection: Chronic melioidosis is an infection that
involves the organs of the body. These typically include the joints, viscera,
lymph nodes, skin, brain, liver, lung, bones, and spleen.
Melioidosis is diagnosed with a microscopic evaluation of a sputum
sample in the laboratory. A blood test is useful to detect early acute
cases of melioidosis, but it can not exclude the illness if it is
The treatment of melioidosis involves antibiotics and depends on the
location of the disease. For patients with more mild illness,
antibiotics such as chloramphenicol, doxycycline, sulfisoxazole, or
trimethoprim-sulfamethoxazole are considered. The conventional treatment
regimen for patients who are more severely ill is a combination of
chloramphenicol, doxycycline, and cotrimoxazole. Even more severely ill
patients (such as those with active blood infection) may require
intravenous antibiotics, including chloramphenicol, and others. If
sputum cultures remain positive for 6 months, surgical removal of the
lung abscess with lobectomy is considered. Antibiotic treatments may be
necessary from 3 to 12 months.
Melioidosis At A
- Melioidosis is an infectious
disease caused by a bacteria.
- Melioidosis commonly involves
- Melioidosis is diagnosed with
the help of sputum testing.
- Melioidosis is treated with