Melioidosis: Transmission, Symptoms, Treatment, Prevention, Diagnosis

What is Melioidosis?

Melioidosis is a bacterial infection that can be seen in people who come in direct contact with contaminated soil or water. It is also known by the name of Whitmore Disease. Melioidosis is commonly seen in Southeast Asia and some parts of Australia, the prevalence of it in the United States is quite rare according to the Center for Disease Control.[1,2]

The bacterium responsible for Melioidosis is known by the name of Burkholderia pseudomallei which has the tendency to be present both in soil and water. In the United States, the cases of Melioidosis occur in people who have traveled to countries where this condition is prevalent like Malaysia, North Australia, Thailand, and Singapore.[1,2]

People who have a compromised immune system or are older in age are most vulnerable of contracting Melioidosis. Additionally people with underlying medical conditions like diabetes, liver dysfunction, renal dysfunction, cancer, and lung problems are also at increased risk for developing Melioidosis.[1,2]

What Is The Mode Of Transmission Of Melioidosis?

As stated, the primary mode of transmission of Melioidosis to humans is by coming in direct contact with contaminated soil and water. The bacteria can infiltrate the skin surface by entering through cuts and bruises on the skin or a person can inhale contaminated water droplets present in the air through mouth. There is no human to human transmission in cases of Melioidosis. Aside from humans, Melioidosis can also be seen in certain animals like sheep, goats, horses, cats, and dogs.[2]

What are the Symptoms of Melioidosis?

Melioidosis can cause a variety of symptoms in humans. This is because the bacterium can affect various organs of the body. The symptoms begin to surface within two to four weeks of transmission of exposure to the bacterium. However, in some cases an individual with Melioidosis may remain asymptomatic for years.[2]

The symptoms of Melioidosis depend on the affected part of the body. If the blood gets infected then the patient may experience difficulty breathing, confusion, headaches, fever, pain in the joints, and stomach pains. If the skin gets affected by Melioidosis then the patient will have fever, discharge from the wound through which the bacteria entered the body, pain, swelling and erythema around the affected area[2]

Melioidosis can also affect the lungs. When this happens the patient starts to experience chest pain, frequent bouts of coughing, persistent headaches, fever, and appetite loss. Melioidosis becomes extremely serious if multiple body systems get affected or there is a septic infection. In such cases, the mortality rate of the person increases to 90%. Some of the symptoms of septic form of Melioidosis include chest pain, headaches, fever, seizures, joint pain, and unintentional weight loss.[2]

How Is Melioidosis Diagnosed?

To get to the diagnosis of Melioidosis, the physician first inquires with the patient about the symptoms. The physician will also ask whether the patient has traveled out of the country to an area where Melioidosis may be prevalent. This will be followed by a detailed physical examination.[2]

Since Melioidosis is an infection that resembles other conditions like tuberculosis or pneumonia, it becomes prudent to rule out these conditions before coming to a diagnosis of Melioidosis. This is done by doing a culture of the blood, sputum, pus, and urine. A close observation of the specimens during culture will reveal growth of the bacterium that causes Melioidosis thus confirming the diagnosis.[2]

It is quite rare for physicians to order imaging studies for a diagnosis of Melioidosis but it can be quite helpful in determining the extent to which the disease has progressed and to devise a treatment plan for the patient.[2]

How is Melioidosis Treated?

Intravenous antibiotics are the first line of treatment for Melioidosis. Ceftazidime or meropenem are the choice of drugs that are used to treat this condition. The medications are given for a period of about two weeks.[2]

Post treatment with IV antibiotics, the patient will be prescribed a course of oral antimicrobial medications like trimethoprim-sulfamethoxazole combination. It is mandatory for the patient to complete the course of the medications for Melioidosis to be completely cured and prevent recurrence of the condition.[2]

Can Melioidosis Be Prevented?

Melioidosis is a condition that can be prevented. There are certain precautions that a person can take if he or she visits an area where Melioidosis is quite common. These precautions include.[1,2]

  1. Cover any open wounds or sores so that the bacteria cannot enter the body through this route. This is especially when coming in contact with contaminated water or soil.
  2. It is also essential to wear protective boots and gloves while working in stagnant water or contaminated soil.
  3. In cases where an individual has a preexisting condition like diabetes or a compromised immune system, it is best to consult with a physician before embarking on a trip to a place where there may be chances of contracting a disease like Melioidosis.[2]