MELIOIDOSIS

a bacterial infection in humans and animals caused by Pseudomonas pseudomallei. Transmission to humans occurs through contact of a skin abrasion with contaminated water or soil rather than through direct contact with a contaminated animal. Inhalation of the pathogen also is suspected as a route of infection. The term melioidosis, from the Greek, means a similarity to distemper of asses. Mostly observed in humans in Southeast Asia, the disease may be acute or chronic. Acute melioidosis, which can be fatal, is characterized by fever, chills, cough, bloody and purulent sputum, diarrhea, and abdominal pain. Physical examination may reveal signs of lung inflammation and pus formation, jaundice, and enlargement of the liver and spleen. Chronic melioidosis may follow the acute phase of the disease or may sometimes develop without it. It is associated with inflammation of the bones and lymph nodes and with the formation of abscesses beneath the skin and inside the lungs and abdominal organs. The diagnosis of melioidosis is established by the isolation of Pseudomonas pseudomallei in the sputum, blood, urine, or pus. Long-term treatment with sulfonamides or antibiotics is usually successful, along with surgical drainage of abscesses.