What you need to know about melioidosis

Melioidosis is a disease that happens in contaminated water or soil, when someone comes into contact with certain bacteria.

Many medical professionals, after the pathologist who first described it, also call this disorder “Whitmore’s disease”

Though melioidosis is most prevalent in south-east Asia and northern Australia, according to the Centers for Disease Control and Prevention (CDC), several other countries have reported it as well.

Read on to learn more about melioidosis, including its signs, causes, diagnosis, and options for treatment.

What is melioidosis?

A lady having headache
A person with melioidis-related bloodstream infection may experience headache, breathing problems and fever.

In the United States Melioidosis is rare. In fact there are around zero to five cases on an annual basis according to the CDC.

The condition may occur when someone comes into contact with the Burkholderia pseudomallei bacterium, which is found both in soil and water.

Diagnoses of melioidosis usually occur in those who have traveled to an area outside of the U.S. where melioidosis is more common. Some examples of such fields include:

  • Malaysia
  • northern Australia
  • Singapore
  • Thailand

That said, there are many other countries where people can come into contact with the bacterium and get melioidosis from contract.

People with a chronic medical condition and those with weak immune systems are at an increased risk of melioidosis.

Some examples of such words include:

  • diabetes
  • liver disease
  • kidney disease
  • cancer
  • chronic lung conditions

Symptoms

Melioidosis can affect people in various ways, causing a wide array of symptoms.

Most people will experience the disease within 2–4 weeks of their initial bacterial exposure. However, a person can go years without having to experience any symptoms.

A person can contract the bacterial infection that leads through different areas of their body to melioidosis. Depending on the area of the body specific symptoms can occur.

These examples include:

Bloodstream infections

These may cause the following symptoms:

  • breathing problems
  • confusion
  • fever
  • headache
  • joint pain
  • stomach pain

Localized skin infections

These may cause the following symptoms:

  • fever
  • foul-smelling discharge from a wound
  • localized pain
  • redness
  • swelling
  • ulcerated skin appearance

Pulmonary infections

These may cause the following symptoms:

  • chest pain
  • coughing
  • fever
  • headache
  • a loss of appetite

Multisystem, or septic, infections

These may cause the following symptoms:

  • chest pain
  • fever
  • headache
  • joint pain
  • seizures
  • stomach pain
  • weight loss

An estimated 89,000 people die from melioidosis every year worldwide according to an article in the journal Nature Reviews Disease Primers. If a person has a septic melioidosis, death rates are as high as 90%.

Causes

A person who comes into contact with water or soil carrying the bacterium Burkholderia pseudomallei can get melioidosis.

This can happen if a person:

  • comes into contact with contaminated soil, especially via skin cuts or abrasions
  • drinks contaminated water
  • inhales dust or water droplets

Transmission amongst humans is unusual. Nevertheless, a person can have the bacterium transferred to another human.

Treatment

Doctors can actually treat melioidosis infections, and prescribe medications and other treatments to reduce the symptoms caused by the disease.

First, they usually give 10–14 days of intravenous antibiotics, such as ceftazidime or meropenem.

The doctor will then prescribe 3–6 months of oral antimicrobial drugs after this time. These include sulfamethoxazole-trimethoprim and amoxicillin-clavulanic acid.

A person has to complete the melioidosis treatment prescribed in full. It reduces the likelihood of the returning infection.

Diagnosis

A doctor can diagnose melioidosis by asking a person about their symptoms, taking into account their travel history, and doing a physical exam.

Infections with melioidosis can look very similar to other infections. These include tuberculosis and pneumonia. A doctor usually can tell the difference by gathering the person’s samples:

  • blood
  • pus
  • sputum
  • urine

Then a laboratory technician would “culture,” or smear, this specimens on petri plates, where they will be examined for bacterial growth.

If a doctor suspects melioidosis, then imaging scans may also be required. Including CT and MRI scans.

Patients seldom use imaging studies for treatment but can be useful in determining the degree to which a person’s body has been compromised by the disease. Melioidosis, for example, may cause abscesses on the liver, spleen or lungs to develop. These will be evident in the imaging studies.

When to see a doctor

When they suspect they have melioidosis, a person should see their doctor as soon as possible.

This is particularly important if a person has traveled to a country where melioidosis is normal, and where contact with contaminated soil or water may have occurred.

Prevention

There are several strategies to help reduce the risk of melioidsis spreading and contracting. Including:

  • always covering open wounds, especially when coming into contact with stagnant water and soil
  • wearing protective boots, with no holes or rips, when working in soil and stagnant water
  • if working in a healthcare facility, taking the standard safety precautions, such as by wearing a mask, gloves, and a gown

If a person at greater risk of melioidosis— such as those with diabetes or a weak immune system— travels to an area where melioidosis is common, they should discuss other preventive tips and safety precautions with their doctor.

Summary

Melioidosis is a condition which spreads in infected water or soil by coming into contact with bacteria.

If a person believes he has melioidosis, immediate medical treatment is needed.

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