Melioidosis (Whitmore's Disease)

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is the treatment for melioidosis?

The treatment of melioidosis involves antibiotics and depends on the location of the disease.

For patients with more mild illness, the CDC recommends medication with antibiotics such as imipenem, meropenem (Merrem), penicillin, doxycycline (Doryx, Oracea, Monodox), amoxicillin-clavulanic acid (Augmentin, Augmentin XR), ceftazidime (Fortaz, Tazicef), ticarcillin-clavulanic acid (Timentin), ceftriaxone (Rocephin), and aztreonam (Cayston, Azactam). Patients who are more severely ill are given a combination of two of the above medications for three to six months.

After the initial intensive therapy, eradication therapy may be initiated using trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim).

With pulmonary involvement of melioidosis, if cultures remain positive for six months, surgical removal of the lung abscess with lobectomy is considered.

Is it possible to prevent melioidosis?

Prevention of infection in areas where melioidosis occurs includes minimizing risk of exposure to the bacteria.

  • People with compromised immune systems (such as AIDS, cancer, those undergoing chemotherapy, etc.), open skin wounds, diabetes, or chronic renal disease should avoid contact with soil and contaminated water, especially in farm areas.
  • People who work in agriculture should wear proper gear, including work boots, to prevent infection in the feet and legs.
  • Health-care workers should use standard safety precautions, including masks, gloves, and gown to prevent infection.

What is the prognosis for melioidosis?

Untreated, melioidosis is fatal. When treated with antibiotics, severe forms of the illness with sepsis and complications that arise from that condition have an overall mortality rate of approximately 40%.

REFERENCES:

Currie, B., and N. Anstey. "Epidemiology, clinical manifestations, and diagnosis of melioidosis." Aug. 2016. UpToDate.com. <http://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-melioidosis?source=search_result&search=Melioidosis&selectedTitle=1%7E29>.

Currie, B., and N. Anstey. "Treatment and prognosis of melioidosis." Aug. 2016. UpToDate.com. <http://www.uptodate.com/contents/treatment-and-prognosis-of-melioidosis?source=search_result&search=Melioidosis&selectedTitle=2%7E29>.

United States. Centers for Disease Control and Prevention. "Melioidosis." Jan. 26, 2012. <http://www.cdc.gov/melioidosis/index.html>.

Medically Reviewed by a Doctor on 9/8/2016

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