Melioidosis Symptoms & Signs
Signs and symptoms of melioidosis can include symptoms and signs related to bronchitis or pneumonia such as
- fever,
- cough,
- chest pain,
- respiratory distress, and
- abscess formation.
Melioidosis, also called Whitmore's Disease, is an infectious disease caused by a bacterium called Burkholderia pseudomallei (previously known as Pseudomonas pseudomallei). The bacteria are found in contaminated water and soil and spread to humans and animals through direct contact with the contaminated source. The bacteria are also of some concern as a potential agent for biological warfare and biological terrorism.
Melioidosis is similar to glanders disease, which is passed to humans from infected domestic animals.
Risk factors for developing melioidosis infection include
Other possible risk factors that may contribute to infection with melioidosis include steroid and other immunosuppressive therapy, rheumatic heart disease, congestive heart failure, pulmonary hemosiderosis, chronic granulomatous disease, and tuberculosis.
Signs and symptoms of melioidosis can include symptoms and signs related to bronchitis or pneumonia such as
There are several different types of melioidosis, each with its own signs and symptoms.
Melioidosis is minimally contagious. It can be spread from person to person, though it is rare. The most common route of infection with melioidosis is through direct contact with contaminated soil and water, especially though open wounds on the skin. Humans and animals can also acquire the infection by inhaling dust particles or water droplets or ingesting water that is contaminated.
Primary-care providers (PCPs), such as family practitioners, internists, pediatricians, and emergency-medicine specialists may initially treat patients, but individuals with severe complications may be treated by infectious-disease specialists or critical-care specialists.
The diagnosis of melioidosis is made with a microscopic evaluation of a blood, urine, sputum, or skin-lesion sample in the laboratory. A blood test is useful to detect early acute cases of melioidosis, but it cannot exclude the illness if it is negative.
The incubation period for melioidosis ranges from one to 21 days, with an average of nine days to onset of infection. Symptoms typically appear two to four weeks after exposure.
Melioidosis is most frequently reported in southeast Asia, northern Australia, south Asia (including India), and China. The majority of patients are from Thailand, Malaysia, Singapore, and northern Australia. Melioidosis has also been reported in Papua New Guinea and New Caledonia. The bacterium that causes the disease is found in the soil, rice paddies, and stagnant waters of the area. People acquire the disease by inhaling dust contaminated by the bacteria and when the contaminated soil comes in contact with abraded (scraped) area of the skin. Infection most commonly occurs during the rainy season.
In the United States, confirmed cases range from none to five each year and occur among travelers and immigrants, according to the U.S. Centers for Disease Control and Prevention (CDC).
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.
Prevention of infection in areas where melioidosis occurs includes minimizing risk of exposure to the bacteria.
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%.
Amoxicillin and Augmentin (amox-clav) are antibiotics used to treat a variety of bacterial infections that include bronchitis, tonsillitis, sinusitis, pneumonia, laryngitis, skin infections, and urinary tract infections. Amoxicillin is a penicillin antibiotic, and Augmentin or amox-clav chemically is closely related to ampicillin and penicillin.
Amoxicillin and Augmentin have similar side effects such as rash, heartburn nausea, vomiting, diarrhea, abdominal pain, easy bruising or bleeding, and allergic reactions.
Augmentin also causes side effects like gas, bloating, headache, and reversible hepatitis. Both amoxicillin and Augmentin have serious side effects that should be reviewed prior to taking either antibiotic.
Dosage instructions for amoxicillin and Augmentin depend upon the drug and type of bacterial infection being treated. Both antibiotics have drug interactions, and are not recommended if you are pregnant or breastfeeding.
Doxycycline (Vibramycin, Oracea, Adoxa, Atridox, Acticlate, Acticlate Cap, Doryx, Doxteric, Doxy, Monodox, and others) is a synthetic broad-spectrum antibiotic derived from tetracycline. It is used to treat many different types of infections, including respiratory tract infections due to Hemophilus influenzae, Streptococcus pneumoniae, or Mycoplasma pneumoniae. It also is used for the treatment of
It is important to be aware of drug interactions, effects on pregnancy and nursing mothers, as well as common side effects on the user.
Sulfamethoxazole and trimethoprim; cotrimoxazole (Bactrim, Bactrim DS, Septra, Septra DS) is a drug prescribed for urinary tract infections (UTIs), middle ear infections, respiratory infections, pneumonia, chancroid, for the prevention of infections of transplant recipients, and prevention of toxoplasma encephalitis in patients with AIDS. Side effects, dosage, drug interactions, pregnancy and breastfeeding safety information is also provided in the information.