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Melioidosis, also known as pseudoglanders and Whitmore's disease (after Capt Alfred Whitmore) is an uncommon infectious disease caused by a Gram-negative bacterium, Burkholderia pseudomallei, found in soil and water. It exists in acute and chronic forms. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ...
The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...
The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ...
The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ...
The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ...
MedlinePlus (medlineplus. ...
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Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ...
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In medicine, infectious disease or communicable disease is disease caused by a biological agent such as by a virus, bacterium or parasite. ...
Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ...
Binomial name Burkholderia pseudomallei (Whitmore 1913) Yabuuchi et al. ...
The causative organism, Burkholderia pseudomallei, was thought to be a member of the Pseudomonas genus and was previously known as Pseudomonas pseudomallei. This organism is phylogenetically related closely to Burkholderia mallei, the organism that causes glanders. Another closely-related but less virulent bacterium is found in soil in Thailand and is called Burkholderia thailandensis. Species P. fluorescens P. putida etc. ...
Binomial name Burkholderia mallei (Zopf 1885) Yabuuchi 1993 Burkholderia mallei (previously Pseudomonas mallei, Malleomyces mallei) is a gram-negative bipolar aerobic bacterium, a Burkholderia-genus human and animal pathogen causing Glanders; the Latin name of this disease (malleus) gave name to the causative agent species. ...
Glanders is an infectious disease that occurs primarily in horses, mules, and donkeys. ...
Melioidosis is endemic in parts of south east Asia (including Thailand, Singapore, Malaysia, Burma and Vietnam) and northern Australia. Multiple cases have also been described in southern China and Hong Kong, Brunei, Taiwan, India and Laos, and sporadic cases in Central and South America, the Middle East, the Pacific and several African countries. An outbreak at the Paris Zoo in the 1970s ("l’affaire du jardin des plantes") was thought that have resulted from imported animals.
Up to 30% of adults in some endemic areas may test positive for antibodies against B. pseudomallei (depending on the population and test). It affects humans as well as other animals such as goats, sheep, horses and cattle. Cattle, water buffalo, and crocodiles are considered to be relatively resistant to melioidosis despite their constant exposure to mud. The mode of infection is believed to be either through a break in the skin, or through the inhalation of aerosolized B. pseudomallei. Wikipedia does not yet have an article with this exact name. ...
There has also been increasing interest in melioidosis because it has the potential to be developed as a biological weapon. It is classed by the US Centers for Disease Control (CDC) as a category B agent.
Symptoms and signs The incubation period can range from 2 days to several decades, but the median incubation period of acute melioidosis is 9 days. Patients with latent melioidosis may be symptom free for decades; the longest duration between presumed exposure and clinical presentation is 62 years. There is a wide spectrum of severity; in chronic presentations, symptoms may last months, but fulminant infection may present with severe symptoms over hours. Incubation period is the time elapsed between exposure to a pathogenic organism and when symptoms and signs are first apparent. ...
A patient with active melioidosis usually presents with fever. There may be pains in multiple sites around his/her body due to bacteremia and abscess formation. Patients with melioidosis usually have risk factors for disease, such as diabetes, thalassemia, hazardous alcohol use or renal disease. However, otherwise healthy patients, including children, may also get melioidosis. Sepsis (in Greek Σήψις, putrefaction) is a serious medical condition caused by a severe infection. ...
Abscess An abscess is a collection of pus collected in a cavity formed by the tissue on the basis of an infectious process (usually caused by bacteria or parasites) or other foreign materials (e. ...
If there is pulmonary involvement, there may be signs and symptoms of pneumonia. Pneumonia is an illness of the lungs and respiratory system in which the microscopic, air-filled sacs (alveoli) responsible for absorbing oxygen from the atmosphere become inflamed and flooded with fluid. ...
If hepatic or splenic abscesses are present, the patient may present with abdominal pain. If there are brain abscesses present, the patient may present with neurological signs and symptoms. An encephalomyelitis syndrome is recognised in northern Australia. The liver is one of the largest internal organs of the human body. ...
The spleen is a ductless, vertebrate gland that is not necessary for life but is closely associated with the circulatory system, where it functions in the destruction of old red blood cells in holding a reservoir of blood. ...
Comparative brain sizes In animals, the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ...
Melioidosis may also cause osteomyelitis and present with bony pain. In Thailand, parotid abscesses in children are common.Other sites of infection include the urinary tract (with prostatic abscesses common in Australia), skin and soft tissue abscesses. Less common manifestation include intravascular infection, lymph node abscesses, pyopericardium and myocarditis, mediastinal infection, and thyroid and scrotal abscesses and ocular infection. Osteomyelitis is an infection of bone, usually caused by pyogenic bacteria or mycobacteria. ...
The parotid gland is the largest of the salivary glands. ...
Diagnosis A definite history of contact with soil may not be elicited as melioidosis can be dormant for many years before becoming acute. Attention should be paid to a history of travel to endemic areas in returned travellers. Patients with diabetes mellitus often have a more serious presentation of melioidosis. Some authors recommend considering possibility of melioidosis in every febrile patient with a history of traveling to and/or staying at endemic areas.
The Differential diagnosis is extensive; melioidosis may mimic many other infections, including tuberculosis. In medicine, differential diagnosis (sometimes abbreviated DDx) is the systematic method physicians use to identify the disease causing a patients symptoms. ...
Tuberculosis (commonly shortened to TB) is an infection caused by the bacterium Mycobacterium tuberculosis, which most commonly affects the lungs (pulmonary TB) but can also affect the central nervous system (meningitis), lymphatic system, circulatory system (Miliary tuberculosis), genitourinary system, bones and joints. ...
A definitive diagnosis can be made by growing B. pseudomallei from any site, including blood cultures, pus aspirated from an abscess, sputum or urine cultures. A throat swab is not sensitive but is 100% specific if positive. Ashdown's medium, containing gentamicin, may be required for cultures from non-sterile sites. Burkholderia cepacia medium may be a useful alternative selective medium in non-endemic areas.
There is also a serological test for melioidosis, but this is not commercially available in most countries. A high background titre may reduce the positive predictive value of serology in endemic countries.
If clinically indicated, CT scans (or, in some cases, ultrasound scans) of the thorax and abdomen are useful to investigate for the presence of abscesses and to rule out other diseases.
Treatment Intravenous ceftazidime is the drug of choice for treatment of acute melioidosis. Intravenous amoxicillin-clavulanate (co-amoxiclav), meropenem or imipenem are also active. Intravenous antibiotics should be given for at least 10-14 days. Following the treatment of the acute disease, it is recommended that oral antibiotics such as co-trimoxazole be used for three to six months to clear the organism from the body, so as to prevent a recurrence. A clinical trial has established that the combination of cotrimoxazole and doxycycline is as effective as, and better tolerated than, the combination of cotrimoxazole, doxycycline and chloramphenicol. An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ...
Ceftazidime is an antibiotic which eliminates bacteria that cause many kinds of infections, including lung, skin, bone, joint, stomach, blood, gynecological, and urinary tract infections. ...
Co-amoxiclav is the British Approved Name, in the British Pharmacopoeia, for the combination antibiotic containing amoxicillin and clavulanic acid. ...
Imipenem is an intravenous beta-lactam antibiotic developed in 1985. ...
An antibiotic is a drug that kills or slows the growth of bacteria. ...
Co-trimoxazole (abbreviated SXT) is a bacteriostatic antibiotic combination of trimethoprim and sulfamethoxazole, in the ratio of 1 to 5, used in the treatment of a variety of bacterial infections. ...
Prognosis Before the era of modern antibiotics, the septicemic form of melioidosis had a high mortality rate exceeding 90%. With modern antibiotics, the mortality rate is about 10% for uncomplicated cases but up to 80% for cases with severe sepsis. It seems certain that access to intensive care facilities is also important, and probably explains why total mortality is 20% in Northern Australia but 40% in Northeast Thailand.
Recurrence may occur in 10-20% of patients. Risk factors include poor compliance with eradication therapy and duration of eradication therapy less than 8 weeks. Molecular studies have established that the majority of recurrences are due to the original infecting strain, but a significant proportion of recurrences in endemic areas may be due to reinfection, particularly after 2 years.
Prevention There are only few cases documented for person-to-person transmission; no isolation is required for patients with melioidosis. Lab workers should handle Burkholderia pseudomallei under PC3 isolation conditions, as laboratory acquired melioidosis has been described.
In endemic areas, people (rice-paddy farmers in particular) are warned to avoid contact with soil, mud and surface water where possible. Case clusters have been described following flooding and cyclones and probably relate to exposure. Other case clusters have related to contamination of drinking water supplies. Populations at risk include patients with diabetes mellitus, chronic renal failure, chronic lung disease or patients with an immune deficiency of any kind. The effectiveness of measures to reduce exposure to the causative organism have not been established. A vaccine is not yet available. For the disease characterized by excretion of large amounts of severely diluted urine, see diabetes insipidus. ...
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