Source:
www.medicinenet.com, and
article Elsevier, "Acta Tropica", feb 2000

What is melioidosis?

Melioidosis is an infectious disease caused by a bacteria called "Pseudomonas pseudomallei."

Where 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.

How does 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.

How is melioidosis diagnosed?

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 negative.

How is melioidosis treated?

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.

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