Melioidosis

Melioidosis
Melioidosis is an infectious disease caused by
the bacterium Burkholderia pseudomallei, also
called Whitmore's disease.

This bacteria is most commonly found in

Southeast Asia, especially in Thailand and in
Northern Australia.

It was first discovered in Australia in far northern

Queensland in 1962, but has now spread
progressively to the west and south.
 Bacteria
Burkholderia
pseudomallei is found
in the soil, rice
paddies, and muddy
waters of these areas.

Polluted and
contaminate
atmosphere
contributes for
spread
 Bacteria
B.pseudomallei is a
small, motile,
aerobic Gram ve

Grows at even 420c

It is a gram
negative bacteria
with a safety pin
like appearance.
 Spread of Burkholderia
pseudomallei Infections
Burkholderia pseudomallei is a facultative
(enabling) intracellular pathogen.

It is pathogenic because of its ability to invade,

resist factors in serum, and survive
intracellularly.

It is easily contracted by inhaling dust

containing the bacteria or by having contact
between contaminated soil and cuts or scrapes
of the skin
 How Melioidosis is
spread
Humans and animals (sheep, goats
and horses) are believed to acquire the
infection by inhalation of dust,
ingestion of contaminated water and
contact with contaminated soil
especially through skin abrasions.

Melioidosis can also spread from

person to person by contact with the
body fluids of an infected person.
 Human Infections
initiated
Human infections
are initiated with
contamination
of skin
abrasions.

By Ingestion

By inhalation.
 Pathogenesis
The disease can manifest as Acute,
Sub acute, and Chronic disease
Incubation may be as short as 2 3
days
Latent infections can occurs after
months to years
 Progress of Infection
The infection starts with non specific
lesion at the inoculum, where there
can be break in the skin.
Lead to septicemia
Most common form is pulmonary
infection
Can lead to suppurative infection and
bacterimia
 Respiratory Infection
The most dangerous
infection can be
associated with
respiratory infection
Can lead to suppurative
lesions.
Consolidations of upper
lobe of the lung
Can mimic tuberculosis.
Progressive illness can
produce cavities
 Spreading lesions
Systemic infections
spread from the
primary lesions on
the skin.

Can spread to
lungs, Myocardium,
Liver and Bone.
 Who are at risk
Individuals with diabetes are at a higher risk for
contracting melioidosis.

About 40% of meliodiosis patients are diabetic.

Other factors that may increase the risk of

contracting meliodiosis are excessive alcohol
consumption, chronic renal disease, and chronic
lung disease.

However, even healthy adults and children are

can infect.
 Incubation period
Incubation period: 2 days to years
 Signs & Symptoms
Latent infection
Most infections asymptomatic
Clinical forms
Acute pulmonary infection
Most common
Focal infection
Septicemia
Neurological (rare)
 Acute Pulmonary Infection
Most common form
High fever, headache
Dull aching chest pain
Cough, tachypnea, rales
Chest X-rays
Upper lobe consolidation
Nodular lesions
Pleural effusion
 Focal(Local) Infection
Abscessor granuloma
formation
Skin
Bone and/or muscle
Joints
Internal organs
Genitourinary
Nervous system (infrequent)
 Septicemic Melioidosis
Acute onset
High fever, tachypnea, dyspnea,
myalgia, hepatosplenomegaly,
septic shock
Concurrent disease
Mortality
90% without treatment
50% with treatment
 Control and Prevention

Avoid contact with soil and water

in endemic areas
Use care during necropsy of
infected animals
Thorough cleaning of wounds
Chlorination of water effective
against organism
 Diagnosis
Melioidosis is diagnosed by
isolating Burkholderia
pseudomallei from the
blood, urine, sputum, or
skin lesions.

Detecting and measuring

antibodies to the bacteria
in the blood.

Gram stain of the material

from skin lesions, sputum
 Treatment
Asthe disease carries high mortality, a
prompt and effective treatment is highly
essential

Treatment
Systemic antibiotics
Tetracyclnes, Sulfonamides,
Trimethoprim-Sulphmethoxazole are effective.
Ceftazidime is highly effective
Surgical drainage of skin wounds

No vaccine available
 Duration of Antibiotic
Treatment
Theduration of treatment should at
least 8 weeks.

The treatment lasting 6moths to 1

year are considered in
immunosuppressive conditions.
 Control and Prevention
Avoid contact with soil and water
in endemic areas
Use care during necropsy of
infected animals
Thorough cleaning of wounds
Chlorination of water effective
against organism
 Melioidosis use as a
Bioweapon
Easy to disseminate
Moderate morbidity
Moderate mortality
Specific diagnostics required
Very stable in the environment
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