Chronic melioidosis, relapse and latency

Chronic melioidosis is the presence of symptoms for two or more months prior to presentation, and may mimic many diseases, including tuberculosis and cancer. Latent melioidosis is a retrospective term used to describe individuals who develop clinical features of infection many months or years after exposure to Burkholderia pseudomallei and presumed infection. There is usually no recollection of a febrile illness around the time of exposure in these cases, and the onset of clinical melioidosis is often associated with a deteriorating host immune response. Recurrentmelioidosis is the development of a further episode of B. pseudomallei infection and is due to relapse following failure to eradicate the organism, or re-infection with a new B. pseudomallei strain. Risk factors for relapse include short duration and choice of antimicrobial therapy for the primary infection; no risk factors have been identified for re-infection other than re-exposure to B. pseudomallei. Understanding specific risk factors for relapse and re-infection could result in better preventive strategies.