MELIOIDOSIS

An infectious disease caused by a bacterium called Burkholderia pseudomallei (previously known as Pseudomonas pseudomallei).

  • Organism is found in contaminated water and soil.
    • Route of contamination: direct contact with contaminated source.
    • Potential agent for biological warfare and biological terrorism.
  • Similar to glanders disease, which comes from infected domestic animals.
  • Other name: Whitmore’s Disease.
  • Symptoms most commonly stem from lung disease.
    • Infection can form a cavity of pus (abscess).
      • Effects can range from mild bronchitis to severe pneumonia.
      • May experience fever, headache, loss of appetite, cough, chest pain, and general muscle soreness.
      • Can also be localized to infection on the skin (cellulitis) with associated fever and muscle aches.
        • Chronic form – spread from the skin through the blood affecting the heart, brain, liver, kidneys, joints, and eyes.
      • Person-to-person spread is possible.

DIAGNOSIS

Physician may do/request:

  • History & Physical Exam
  • Laboratory tests
    • Urinalysis
    • CBC
    • Sputum analysis
    • Skin lesion smear
    • Blood tests

 

RECOMMENDED MEDICATIONS

  • Antibiotics
    • For mild illness: imipinem, penicillin, doxycyciline, amoxicillin-clavulanic acid, ceftazidime, ticarcillin-clavulanic acid, ceftriaxone, aztreonam.
    • For severe illness: Combination of 2 of the above drugs for 3-6 months.
    • If with pulmonary involvement: if cultures remain positive for 6 months, surgery for lung abscess excision with lobectomy is considered.

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