Melioidosis: Etiology, Clinical Features, and Treatment

Etiology: Melioidosis is caused by the gram-negative bacterium Burkholderia pseudomallei, which is commonly found in soil and water in endemic regions like Southeast Asia and northern Australia. Infection typically occurs through inoculation, inhalation, or ingestion of the bacteria.

Clinical Features:

1. Pulmonary: Pneumonia, lung abscesses, and pleural effusions are common, often presenting with cough, fever, and chest pain.
2. Septicaemia: Life-threatening with high mortality, characterized by disseminated infection and multiple organ involvement.
3. Skin and soft tissue: Ulcers, abscesses, and cellulitis may be present.
4. Osteomyelitis: Bone infections can occur, causing severe pain and swelling.
5. Neurological: Brain abscesses, meningitis, and encephalitis are possible.

Treatment:

• Initial treatment: Intravenous ceftazidime or carbapenems (e.g., imipenem, meropenem) for at least 10–14 days.
• Oral eradication therapy: Long-term treatment (3–6 months) with doxycycline and trimethoprim-sulfamethoxazole (TMP-SMX) to prevent relapse.
• Supportive care: May include mechanical ventilation, fluids, and management of complications.

Early diagnosis and treatment are crucial due to the high mortality rate. Consult a healthcare professional for specific advice.