| Disease/Syndrome |
Melioidosis |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Chronic |
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| Synonyms |
Whitmore disease; Burkholderia pseudomallei infection; |
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| Biomedical References |
Search PubMed |
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| Comments |
These saprophytic bacteria may infect humans and other animals. A variety of syndromes are seen. 5-20% of farmers in endemic areas have antibodies without a history of disease. Some patients develop pulmonary consolidation, necrotizing pneumonia, or rapidly fatal septicemia. The disease may be confused with typhoid fever or tuberculosis. Findings may include pulmonary cavitation, empyema, and osteomyelitis. Rice farmers in Thailand are at risk for this disease. Infection occurs through contact with contaminated water or soil through breaks in the skin, inhalation, or ingestion. Some chronic diseases (diabetes, cirrhosis, alcoholism, and renal failure) increase the risk of contracting the disease. [CCDM, p. 354-6] The disease may present as sepsis and "overwhelming necrotizing pneumonia." Other findings may include pleuritic chest pain, normal or elevated WBC count, arthritis, meningitis, septic shock, abdominal pain, diarrhea, pharyngitis, skin pustules, lymphadenitis, cyanosis, myalgias, and abnormal liver function tests. Chest x-ray findings may include pleural effusions, nodular infiltrates, cavitation, and consolidation. [Merck Manual, p. 1465] Liver and spleen abscesses are common in patients with septicemic melioidosis. Unlike TB, hilar adenopathy is not usually found in pulmonary infections caused by B. pseudomallei. Acute suppurative parotitis caused by B. pseudomallei occurs in about 1/3 of pediatric cases of melioidosis. [Guerrant, p. 383-4] Presentations of 363 cases in Northern Australia were pneumonia (81), genitourinary (21), skin abscesses (45), soft tissue abscesses (11), neurologic (12), and osteomyelitis/septic arthritis (5). Mortality was 5% in pneumonia cases and 25% in neurologic cases. Genitourinary diseases include prostate abscesses and orchitis. Neurologic diseases include encephalomyelitis, cranial nerve palsies, brain abscesses, motor weakness, and paralysis. [PPID, p. 2622-31] |
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| Latency/Incubation |
2 days to weeks, months, or years; |
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| Diagnostic |
Culture; EIA for IgG (>90% sensitive and specific) and IgM (>90% sensitive for active disease); [Wallach, p. 918] IHA and ELISA assays are useful for ill tourist returning from endemic area, but culture is definitive test. [PPID, p. 2628] |
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| ICD-9 Code |
025 |
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| Effective Antimicrobics |
Yes |
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| Scope |
Southeast Asia, the Philippines, Iran, Turkey, northeastern Australia, Papua New Guinea, Guam, Burkina Faso (Upper Volta), Ivory Coast, Sri Lanka, Madagascar, Brazil, Ecuador, Panama, Mexico, Haiti, El Salvador, Puerto Rico and Aruba |
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| Reference Link |
CDC - Melioidosis |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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