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Melioidosis and glanders 

Melioidosis and glanders
Melioidosis and glanders

Sharon J. Peacock

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date: 27 February 2021

Melioidosis is a serious infection caused by the soil-dwelling Gram-negative bacillus Burkholderia pseudomallei. It is most commonly reported in north-east Thailand and northern Australia, but is increasingly recognized around the world. Infection is predominantly acquired through bacterial inoculation, often related to occupation, and mostly affects adults between the fourth and sixth decade who have risk factors such as diabetes mellitus and renal impairment. Clinical features are very varied, ranging from a septicaemic illness (the most common presentation), often associated with concomitant pneumonia (50%) and other features including hepatic and splenic abscesses, to a chronic illness characterized by fever, weight loss, and wasting. Aside from supportive care and drainage of collections of pus, treatment requires prolonged antimicrobial therapy, with a parenteral phase of 10 to 14 days (ceftazidime or a carbapenem) followed by oral therapy for 12 to 20 weeks (trimethoprim-sulfamethoxazole).

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