Melioidosis

What it is

From: Orphanet

A tropical infectious disease caused by the Gram-negative bacterium Burkholderia pseudomallei, which is present in soil and water in tropical countries. Melioidosis can present itself in many ways, including pneumonia, sepsis and abscess formation.

Reported clinical features and what the terms mean

The following findings are associated with this condition in Orphanet. They are not a checklist for diagnosing yourself, and they do not all occur in every affected person. Some are examination, imaging or laboratory findings that cannot be recognised at home.

The frequency labels describe how often a finding was reported among people with the condition in the source. They do not give the chance that a person with that symptom has the condition. Definitions below reproduce HPO terminology; they explain the term, not the likely severity in an individual.

Acute infectious pneumonia · Frequent (79-30%)

Acute inflammation of the lung due to an infection.

Bacteremia · Frequent (79-30%)

Presence of viable bacteria in the blood.

Fever · Frequent (79-30%)

Body temperature elevated above the normal range.

Lung abscess · Frequent (79-30%)

A circumscribed area of pus or necrotic debris in lung parenchyma, which leads to a cavity, and after formation of bronchopulmonary fistula, can manifest as an air-fluid level inside the cavity.

Pneumonia · Frequent (79-30%)

Inflammation of any part of the lung parenchyma.

Respiratory tract infection · Frequent (79-30%)

An infection of the upper or lower respiratory tract.

Sepsis · Frequent (79-30%)

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.

Shock · Frequent (79-30%)

The state in which profound and widespread reduction of effective tissue perfusion leads first to reversible, and then if prolonged, to irreversible cellular injury.

Abnormality of the spleen · Occasional (29-5%)

An abnormality of the spleen.

Brain abscess · Occasional (29-5%)

A collection of pus, immune cells, and other material in the brain.

Cellulitis · Occasional (29-5%)

A bacterial infection and inflammation of the skin und subcutaneous tissues.

Cutaneous abscess · Occasional (29-5%)

A circumscribed area of pus or necrotic debris in the skin (within the epidermis or dermis).

Hepatitis · Occasional (29-5%)

Inflammation of the liver.

Liver abscess · Occasional (29-5%)

A localized, circumscribed collection of purulent material (pus) within the liver parenchyma, typically resulting from a bacterial, parasitic, or fungal infection. Unlike hepatitis, which is often diffuse, an abscess is a focal lesion.

Other findings in the same source

From: Orphanet

Additional reported features include Osteoarthritis (Occasional (29-5%)); Splenic abscess (Occasional (29-5%)); Unusual skin infection (Occasional (29-5%)); Septic arthritis (Occasional (29-5%)); Abnormal parotid gland morphology (Very rare (<4-1%)); Abnormality of the genitourinary system (Very rare (<4-1%)); Foot osteomyelitis (Very rare (<4-1%)); Parotitis (Very rare (<4-1%)); Prostatitis (Very rare (<4-1%)). This is a selected summary, not a complete description of the condition.

When it may begin

From: Orphanet

All ages

Frequency and the population described

From: Orphanet

Annual incidence: 1-5 / 10 000; Australia; Value and class. Annual incidence: 1-5 / 10 000; Thailand; Value and class.

Which doctor should you see?

The suggested department for discussing Melioidosis is Infectious Diseases, with a general physician / infectious disease specialist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which exposure or organism is suspected, and what evidence would confirm it?
• Are precautions, vaccination or advice for close contacts relevant to this infection?
• What should happen if symptoms worsen or do not improve as expected?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Melioidosis. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.