Melioidosis

Facts You Should Know About Melioidosis

1. A bacterial infection with Burkholderia pseudomallei causes melioidosis.
2. People experiencing respiratory distress, seizures, or chest pain should seek immediate medical care.
3. Treatment of melioidosis incorporates antibiotics and depends on the site of the infection.

• Melioidosis is most common in tropical climates, especially in Malaysia, Singapore, Thailand, and northern Australia.
• There are several forms of melioidosis, including a localized infection, lung disease, bloodstream infection, and disseminated or widespread infection in the body.
• Contact with contaminated water or soil transmits the bacteria to humans.
• Animals, including dogs, cats, cattle, swine, sheep, goats and horses, may also become infected.
• Antibiotics treat melioidosis.
• Without treatment, the condition can be fatal.
• In areas where the bacteria are common, preventive measures can include protective clothing and footwear to reduce contact with soil and water.

Melioidosis is an infectious disease that can affect both humans and animals. Melioidosis is also referred to as Whitmore's disease.

The Burkholderia pseudomallei bacteria that cause melioidosis can be found in water and soil. Animals and people get the infection by inhalation of contaminated dust or water droplets, drinking contaminated water, or contact with contaminated soil, especially through skin abrasions. Though it is rare for a person to spread the infection to another person, this has occurred. Cats, dogs, horses, cattle, pigs, sheep, and goats are among the types of animals that can develop this bacterial infection.

Risk factors for developing melioidosis include travel to or residing in areas where the disease is common. Worldwide, most cases have been reported in Thailand, Malaysia, Singapore, and northern Australia. Melioidosis can affect healthy people, but those with conditions that weaken the immune system are at greater risk. Health conditions that increase the risk include HIV, cancers, chronic lung disease (including COPD), liver disease, thalassemia, diabetes, and chronic kidney disease.

The incubation period, or time between exposure to the bacteria and the appearance of symptoms, is usually from 1-21 days. There is evidence that the condition can persist without causing symptoms and reactivate at a later time.

While rare instances of melioidosis being spread from person to person have been reported, it is usually not a contagious condition. The main method by which people get melioidosis is by contact with contaminated water or soil.

Melioidosis has a wide variety of symptoms and signs. The symptoms and signs are similar to those of other conditions, so it may not be easily diagnosed. There are also several different types of melioidosis:

• Local infection in one part of the body: Symptoms and signs include swelling, pain, and fever. An ulcer or abscess may form at the affected site.
• Lung (pulmonary) infection (pneumonia) with symptoms that include cough and chest pain: Fever, loss of appetite, and headache are other possible symptoms. Pneumonia is the most common form of melioidosis.
• Bloodstream infection, which may have features such as high fever, headache, difficulty breathing, mental status changes, joint pain, and abdominal pain
• Widespread or disseminated infection, characterized by fever, weight loss, chest or abdominal pain, headaches, seizures, and muscle and joint pains

The diagnosis of melioidosis relies on isolating the Burkholderia pseudomallei bacteria from an infected person's blood, sputum, urine, abscess fluid, or skin lesions. In some cases, medical professionals may use a blood antibody test to diagnose melioidosis, but this is less reliable than culturing the organism.

Antibiotics treat melioidosis, and prompt treatment can positively affect the outcome of the illness. Treatment usually consists of an intravenous antibiotic (typically ceftazidime or meropenem) for 10-14 days followed by oral antibiotics, such as trimethoprim-sulfamethoxazole (Bactrim) or amoxicillin/clavulanic acid (Augmentin) for 3 to 6 months.

The prognosis, or outlook, depends on the type of symptoms and signs and the underlying health status of the individual. Melioidosis can be fatal if not treated. The severe forms of the condition, even when treated, may have a high death rate in people with weakened immune systems or chronic diseases.

In areas where the bacteria are prevalent, it is possible to try to take certain measures to prevent contact with soil and water, particularly if there are open sores on the skin. When working outdoors, wearing boots may help prevent infection through the feet and lower legs.