Melioidosis is an infectious disease caused by the bacteria Burkholderia pseudomallei, found in water and soil in Southeast Asia and other tropical locations. It can be transmitted to humans and animals through contaminated sources and can result in four different symptom patterns. Diagnosis involves isolating and culturing the bacteria from body fluids or tissues, and treatment typically consists of penicillin or penicillin-analog antibiotics.
Melioidosis is an infectious disease caused by a species of bacteria called Burkholderia pseudomallei. Also known as Nightcliff’s gardener’s disease and Whitmore’s disease, the disease is mostly found in Southeast Asia and other tropical locations. Burkholderia pseudomallei’s normal habitat is water and soil, and the infection can spread to humans who drink contaminated water or come into contact with contaminated soil.
The pathogenic bacterium is endemic to Southeast Asia, which means that it is always present in the population. It is also common in the South Pacific, the Middle East, India and Africa. Melioidosis is primarily a disease of the tropics, however it is considered of concern to the Western world due to its potential as a biological warfare agent.
Animals such as cattle, horses, pigs, sheep, goats, cats and dogs can also become infected and transmit the disease. As with humans, infection occurs as a result of direct contact with contaminated sources. Direct transmission between humans is extremely rare, but can occur during sexual or other intimate contact if bodily fluids are exchanged.
The symptoms of melioidosis can fall into one of four different symptom patterns. The first is acute localized infection, which is the result of an infection that begins as a skin lesion. Early symptoms include body aches and fever. While these symptoms aren’t serious in themselves, this form of infection can progress rapidly to infecting the bloodstream, which is potentially fatal.
An acute bloodstream infection produces symptoms such as headache, difficulty breathing, muscle aches and pains, diarrhea, and confusion. This form of the disease occurs most often in people who have suppressed immune systems. People with AIDS, diabetes and kidney failure are especially vulnerable.
When illness is due to inhaled Burkholderia pseudomallei, the result is usually a lung infection such as bronchitis or pneumonia. Possible symptoms include headache, high fever, body aches, chest pain, and cough. The fourth form of infection is called chronic suppurative infection. This involves one or more organs, which may include the skin, liver, lung, spleen, bones, brain and lymph nodes.
In order for melioidosis to be diagnosed, Burkholderia pseudomallei must be isolated and cultured from a body fluid or tissue sample taken from the patient. For this purpose, samples such as faeces, urine or blood are normally used. Another method of diagnosis is the measurement of specific antibodies to the bacteria. Detection of such antibodies indicates that the patient has been in contact with the bacteria, but not necessarily that they have an active infection.
Treatment of melioidosis typically consists of penicillin or penicillin-analog antibiotics. Several medications can be used, including penicillin, amoxicillin, doxycycline, cetriaxone, and aztreonam. Most types of infection are not fatal and respond well to antibiotic treatment; however acute bloodstream infection is a serious condition that is often fatal.
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