MelioidosisA24.3

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 15.06.2022

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Synonym(s)

Malleoidosis; Melioidosis; Pseudomalleus; Pseudo-root; Stanton's disease; Whitmore Disease

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HistoryThis section has been translated automatically.

Whitmore and Krishnaswami, 1912

DefinitionThis section has been translated automatically.

Bacterial infectious disease in rats, cats, pigs, rarely also in humans.

PathogenThis section has been translated automatically.

Pseudomonas pseudomallei (Burkholderia pseudomallei), a gram-negative rod-shaped bacterium. The ability to intracellular persistence and the ability to form so-called viable but not culturable (VBNC) variants enables the pathogen to remain in the organism for years largely unaffected by the immunological defence of the affected person.

Occurrence/EpidemiologyThis section has been translated automatically.

In tropical areas, especially Ceylon, the rear Indies, Indonesia, Australia, Madagascar. Incidence in endemic areas: 4-17/100.000 inhabitants/year.

EtiopathogenesisThis section has been translated automatically.

Aerogenic transmission of the pathogen, rarely through skin lesions or food.

Clinical featuresThis section has been translated automatically.

Acute pleuro-pneumonic picture, sepsis, purulent melting metastases in skin, internal organs, muscles. Petechial exanthema. In the second week of illness, possible development of lentil-sized pustules.

Primary localized infection of the skin after inoculation of the pathogen with development of phlegmonous inflammation is also possible.

DiagnosisThis section has been translated automatically.

Cultural pathogen detection in sputum, pus, blood, urine. CBC, agglutination test, intradermal test.

Differential diagnosisThis section has been translated automatically.

Malleus; tuberculosis; typhoid; cholera; malaria; syphilis; mycoses.

TherapyThis section has been translated automatically.

Early and sufficiently long therapy (at least 8 weeks) with Ceftazidim (e.g. Fortum) 120 mg/kg bw/day i.v. is the method of choice.

Alternatively, combination therapies e.g. with doxycycline (e.g. Doxycyclin Heumann) 2 times/day 100 mg p.o., trimethoprim/sulfamethoxazole(e.g. Cotrimox-Wolff Tbl.) 10/50 mg/kg bw/day p.o. are described.

Alternatively: Imipenem (e.g. Zienam®). Adults: 3-4 times/day 0.5-1.0 g i.v., infants: 60 mg/kg bw/day distributed over 4 ED.

LiteratureThis section has been translated automatically.

  1. Chaowgul W et al (1993) Relapse in melioidosis: incidence and risk factors. J Infect Dis 168: 1181-1185
  2. Cheng AC et al (2004) Adjunctive granulocyte colony-stimulating factor for treatment of septic shock due to melioidosis. Clin Infect Dis 38: 32-37
  3. Soffler C et al (2014) Pathogenesis of percutaneous infection of goats with Burkholderia pseudomallei: clinical, pathologic, and immunological responses in chronic melioidosis. Int J Exp Catholic 95:101-119
  4. Suputtamongokol Y et al (1994) Ceftazidime vs amoxicillin/Clavulanate in the treatment of severe melioidosis. Clin Infect Dis 19: 864-853
  5. White NJ (2003) Melioidosis. Lancet 361: 1715-1722
  6. Whitmore A, Krishnaswami CS (1912) An account of the discovery of a hitherto undescribed infective disease occurring among the population of Rangoon. Indian Med Gazette 47: 262-267

Authors

Last updated on: 15.06.2022

Author: Prof. Dr. med. Peter Altmeyer