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PubMed1992

Pseudomonas pseudomallei and melioidosis in China.

Though melioidosis has been reported since 1912, it is still a new problem for most Chinese physicians and medical scientists. Because of the lack of understanding and clinical experiences in melioidosis, none had been reported until 1990 in the mainland of China. In view of China's open policy and health work the natural foci of Pseudomonas pseudomallei in South China, ie. Hainan, Guangdong and Guangxi Provinces, should be given sufficient concern. Efforts should be made in training physicians in the endemic areas to improve their knowledge about the disease and to avoid misdiagnosis.

Animals↗
PubMed1992

The prevalence of the indirect hemagglutination test for melioidosis in children in an endemic area.

The indirect hemaglutination test for melioidosis was studied in 295 children who live in the northeastern part of Thailand. Sixty-seven children (22.7%) were healthy children who came to the well baby clinic. Two hundred and twenty-eight children (77.3%) came to the hospital because of some illnesses other than melioidosis. Eighty-three percent of the children had an IHA titer of at least 1:10 or greater. Twenty-two percent had an IHA titer of 1:80 or greater. The prevalence of positive IHA titer and the mean titer were higher in the older age group. The age of children should be considered when interpreting IHA titer for milioidosis.

Adolescent↗
PubMed2003

[Identification of the causative agents of glanders and melioidosis by polymerase chain reaction].

Burkholderia mallei and B. pseudomallei are causative agents of glanders and melioidosis, respectively, i.e. severe and fatal infection diseases of man and animal. The computer-based analysis of the 23S rRNA gene sites was used for selecting the primers. Two pairs of primers were chosen for the identification of B. mallei and Bpseudomallei. DNAs from 48 B. pseudomallei and 15 strains of B. mallei, unlike from other geterological bacteria, were positively amplified. Therefore, the method of polymerase chain reaction can be used in laboratory diagnosis of glanders and melioidosis.

Animals↗
PubMed2003

A case of nonfatal cutaneous melioidosis.

Melioidosis is a tropical infectious disease caused by the gram-negative bacterium Burkholderia pseudomallei. It is endemic in many parts of the world, including Southeast Asia, and has a mortality rate of about 45%. We report a case of localized nonfatal cutaneous melioidosis presenting as a persistent ulcer in an otherwise healthy young woman.

Adult↗
PubMedDate not supplied

The neuropathology of melioidosis: two cases and a review of the literature.

Melioidosis is an infectious disease caused by Burkholderia pseudomallei and is hyperendemic in the Top End of the Northern Territory of Australia, as well as being widespread throughout tropical south east Asia. The infection is primarily acquired via the inoculation of compromised surface tissues by contaminated soils and water and it can cause an acute, rapidly fatal illness. Although pneumonia is the commonest manifestation, neurological presentations have been described, most notably encephalomyelitis. This paper presents the neuropathology of 2 fatal cases of neurological melioidosis and reviews the relevant literature.

Brain↗
PubMed2004

Clinical experience with treatment of melioidosis in children.

We describe the treatment and follow-up results of 30 children with culture-proven melioidosis seen during 1994-1999. Twelve patients had septicemia, and 18 patients had localized infection. Ceftazidime with or without trimethoprim-sulfamethoxazole were used for the acute treatment of severe melioidosis. Oral trimethoprim-sulfamethoxazole was given in the eradication phase in 4 patients with septicemia and in 12 patients for the treatment of localized infection. Trimethoprim-sulfamethoxazole in combination with doxycycline were given to 4 patients, whereas doxycycline alone was given to 2 patients older than 8 years old. No serious adverse reaction was reported. Three patients died suddenly. Twenty-five patients could be followed up; 24 patients were well.

Adolescent↗
PubMed2005

Musculoskeletal melioidosis masquerading as diabetic amyotrophy.

A patient with musculoskeletal melioidosis masquerading as diabetic amyotrophy is described. A 43-year-old man presented with left thigh pain, fever, malaise and loss of weight. He had diabetes mellitus for six years. He was initially diagnosed with diabetic amyotrophy and was treated conservatively. Recurrence of symptoms prompted further investigations which revealed melioidosis of the left femur. Magnetic resonance imaging showed an enhancing subperiosteal collection. The diagnosis was confirmed by open biopsy and tissue culture. Acute treatment consisted of intravenous ceftazidime for 24 days and oral cotrimoxazole. The patient showed marked improvement clinically and biochemically. He was discharged with oral doxycycline and cotrimoxazole for three months. This disease is eminently treatable, but can be a diagnostic challenge when it presents in an uncommon site.

Adult↗
PubMed2006

Indirect hemagglutination assay in patients with melioidosis in northern Australia.

Melioidosis is caused by the saprophytic organism Burkholderia pseudomallei. The use of the indirect hemagglutination assay (IHA) has found widespread use in areas endemic for this disease. Using this assay, we explored the serologic profile of 275 patients with culture-confirmed melioidosis in the Northern Territory of Australia. Based on a threshold titer of 1:40, the sensitivity of the IHA on admission was 56%. Female patients, those with positive blood cultures, and those with pneumonia independently predicted a negative IHA result. Most patients (68%) with negative admission IHA titers subsequently seroconverted. Most patients (92%) with positive admission IHA titers had persistently positive IHA titers. Relapses were not observed in 36 patients who had a negative IHA at least 1 month after admission, irrespective of initial admission IHA. The IHA has limited utility as a diagnostic test for acute disease, and most patients subsequently have persistently positive titers after recovery from illness.

Adolescent↗
PubMed2005

Melioidosis: the Johor Bahru experience.

A 5 year retrospective review of cases of melioidosis was carried out in Sultanah Aminah Hospital, Johor Bahru. There were 44 new cases of melioidosis which was proven by either blood or pus culture growing Burkholderia pseudomallei from the period between January 1999 and December 2003. Of these, 38 (86.4%) were males compared to only 6 (13.6%) females. Thirty-one (70.5%) were Malays, 7 (15.9%) were Chinese, 5 (11.4%) were Indians and 1 (2.2%) was a Sarawakian. The peak age group was between 50 and 59 years (31.8%). Out of these 44 new cases, only 32 medical records could be retrieved and analysed. Twenty-four out of 32 patients (75%) analysed had diabetes mellitus, 4 had chronic or end stage renal failure (CRF/ESRF) and only 1 had Human Immunodeficiency Virus (HIV). One case of "near drowning" was also recorded. Twenty-one out of 44 patients or 47.7% died, of which 8 (38.1%) died within 24 hours of admission. Pulmonary involvement was recorded in 62.6% of the patients but many had signs and symptoms of multiorgan involvement.

Adolescent↗
PubMed1990

[A study on pathogen antigen and serodiagnosis of Malleus and Melioidosis with McAbs].

A study on pathogen antigen and serodiagnosis of Malleus and Mlioidosis was made with McAbs which are against Ps. mallei or Ps. pseudomallei. The results showed that (1) Ps. mallei and Ps. pseudomallei express different surface antigen types respectively, and there are antigen overlapping in some degree between them; (2) Epitope 2D4 is common to Ps. mallei and Ps. pseudomallei; (3) The antibody which is similar to McAbs 4D4 or 1A9 might be a common serum antibody of Malleus and Melioidosis; and (4) McAb 3A1 is a high specific one which reacts with Ps. pseudomallei only, and with it, it is possible to resolve the immunological problem of distinguishing diagnosis between Malleus and Melioidosis.

Animals↗
PubMed1988

Melioidosis, the great mimicker: a report of 10 cases from Malaysia.

Between 1981 and 1986, 10 consecutive cases of melioidosis were seen at the University Hospital, Kuala Lumpur, Malaysia. They illustrate the amazing guises of melioidosis presenting as: abscesses of the supraspinatus muscle, psoas muscle, brain and liver; three different pulmonary forms; an acute suppurative dermal lesion; an acute septicaemia; and chronic lymphadenitis. The majority had underlying diseases: diabetes mellitus, the commonest, was present in six, out of whom three had previous pulmonary tuberculosis; other predisposing conditions were renal failure, corticosteroid therapy and malnutrition. Three patients who died had pre-existing renal impairment and developed renal failure later, suggesting that the former is a bad prognostic sign. Clinical diagnosis was difficult: all cases were diagnosed bacteriologically. A high level of clinical awareness is necessary, especially when presentation simulates pulmonary or extrapulmonary tuberculosis in patients with diabetes or other compromised states.

Abscess↗
PubMed1988

[Septic melioidosis following a visit to India].

A case is reported of lethal septicemic melioidosis due to Pseudomonas pseudomallei in a 40-year-old woman who had been in India. The epidemiology, clinical findings and management of this unusual disease are discussed. The diagnostic value of serological tests and in vitro sensitivity of Pseudomonas pseudomallei to various antibiotics are outlined. Melioidosis should be considered in the differential diagnosis of any febrile condition in a person returning from a tropical country.

Adult↗
PubMed1984

Cellular immunity (T-cell subset using monoclonal antibody) in tuberculosis, melioidosis, pasteurellosis, penicilliosis; and role of levamisole and isoprinosine.

In vitro and in vivo evaluation of cellular immunity (T-cell subset--using monoclonal antibody--immunofluorescent staining technique; E-rosette formation to 2.4-Dinitrochlorobenzene reaction) were made in tuberculosis, melioidosis, pasteurellosis and penicilliosis. The data demonstrate depressed cellular immunity especially a significant decrease in numbers of T-helper cells and T-helper/T-suppressor subset ratio fell to less than 1.0. Of greater importance, in tuberculous patients and patients with melioidosis treated with levamisole, 150 mg/day, twice a week, along with a specific antitubercular or antimicrobial agent for appropriate duration, improved faster both clinically, microbiologically and in cellular immunity.

Adult↗
PubMed1977

[Membrane antigens of the agents of glanders and melioidosis].

Double immunodiffusion in gel test was used to determine the antigenic composition of the preparations of membranes isolated from the lysozyme spheroplasts of glanders (strain No. 10230) and melioidosis (strain No. C-141) causative agents. The membranes of these microbes proved to contain antigens of cell walls, lipopolysaccharides and the thermolabile membrane antigen proper. A study of antimembrane sera in the agglutination and immunofluorescence tests demonstrated a heterogeneity of the glanders and melioidosis strains under study by the membrane thermolabile antigen.

Animals↗
PubMed1994

Melioidosis. Another etiology of granulomatous osteomyelitis. Report of 2 cases.

Two cases of granulomatous osteomyelitis caused by melioidosis are reported. Histologically, the granulomatous lesions were indistinguishable from tuberculosis and required confirmation with microbiological culture. It is important that melioidosis be considered in the differential diagnosis of granulomatous osteomyelitis since the treatment is quite different from tuberculosis.

Adult↗
PubMed1994

[Epidemiology of melioidosis in China].

From 1975 to 1989, a total of 73 strains of P. pseudomallei was isolated from the water samples and the pathological samples of human and domestic animals in 13 counties and cities located different latitude from four provinces Qiong, Yue, Gui and Xiang in China. Serological investigation demonstrated that the geographical distribution of the organism had a significant correlation with the positive rate of antibodies against P. pseudomallei and the native foci of the organisms distributed over the southern subtropical zone and the edge of tropical zone in Qiong, Yue and Gui. In endemic areas, the positive rates of antibodies against P. pseudomallei in human-beings, horses, oxen and pigs are 3.8%-15.2%, 9.1%-18.4%, 6.6%-33.0% and 35% respectively. The investigation results showed the horses and mules infected by the organism would interfere with quarantine of the animals, meanwhile, the meat contaminated by the bacterium would endanger the public health. In Sept. and Oct. of 1989, three cases in Zhanjiang and Sanya of Hainan were reported, two cases died of acute melioidosis with septicemia, another case was the chronic leg ulcers. So, it was predicated that there could have some cases of melioidosis which were misdiagnosed or missed out.

Animals↗