Clinical features of acute melioidosis

Bart Currie, Wipada Chaowagul, Allen Cheng

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

The majority of infections with Burkholderia pseudomallei are asymptomatic. In disease, theincubation period, clinical presentations of melioidosis, and outcomes are thought to be determined by a combination of bacterial load infecting the individual, putative B. pseudomallei strain differences in virulence, mode of infection and, most importantly, host risk factors for disease. Over 85% of cases of melioidosis are acute presentations, with an incubation period of 1 to 21 days (mean, nine days). Mortality varies depending upon disease severity and access to diagnostic and therapeutic facilities, ranging from over 90% in patients presenting with disseminated disease and septic shock in under-resourced rural locations, to potentially zero in patients without any risk factors who present with localised disease (for example, cutaneous melioidosis). Bacteraemia occursin 40 to 60% of cases, and around half of patients present with pneumonia. Other presentations include: cutaneous melioidosis; septic arthritis and/or osteomyelitis; genitourinary presentations, most notably prostatic abscesses; suppurative parotitis, seen commonly in children in Thailand; bacteraemia without an evident clinical focus; and melioidosis meningo-encephalitis, as seen morecommonly in Australia than elsewhere. Internal organ abscesses are common, as is secondarybacteraemic spread to other foci irrespective of the primary presentation.
Original languageEnglish
Title of host publicationMelioidosis
Subtitle of host publicationA Century of Observation and Research
EditorsNatkunan Ketheesan
PublisherElsevier
ChapterSection IV.1
Pages113-119
Number of pages7
ISBN (Electronic)9780444534798
Publication statusPublished - 2012

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