Melioidosis

Question 1

When should you suspect this disease?

Answer 1

It is endemic in SE Asia and Northern Australia especially during the rainy season.

Question 2

How long can this bacteria remain dormant?

Answer 2

10 to 30 yrs

Question 3

What does Melioidosis share in common with Syphilis?

Answer 3

The great Mimicer or Imitator

Question 4

What is the mortality rate for this infection?

Answer 4

20 to 50%

Question 5

What are the 3 presentations of Melioidosis ?

Answer 5

Subacute Chronic- like TB
Acute Localized
Acute Disseminated

Question 6

What are some specific presentations of this disease?

Answer 6

Parotitis
Skin Infection/ Ulcers
Pneumonia- the most common presentation
ARDS
Abscess of the Liver and Spleen
Prostatitis/ Prostate Abscess
Abscess of the Brian and Bone
Meningoencephalitis
Scleral Suppuration

Question 7

Does Melioidosis induce an immune response?

Answer 7

No. It is felt that a neutrophil defect may cause the absence of a a cellular and humoral defect

Question 8

What is the treatment of Melioidosis?

Answer 8

IV Fortaz 2gms iv q 8hrs for 14 days
then TMP/SMX + Doxycycline high dose for 12 to 20 weeks
If there are neuro sx, IV Fortaz for 4 weeks followed by 6 mos of oral therapy
Chloramphenicol is also useful