Arindam Chakravorty1, Christopher Heath2. 1. MBBS, FRACP, Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA. arindam.chakravorty@health.wa.gov.au 2. MBBS, FRACP, FRCPA, FECMM, MASM, Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA; Department of Microbiology (PathWest Laboratory Medicine), Fiona Stanley Hospital Network, Murdoch, WA; Infectious Diseases Department, Fiona Stanley Hospital, Murdoch, WA; Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA
Abstract
BACKGROUND: Endemic to soils of Northern Australia, Burkholderia pseudomallei is the Gram-negative pathogen responsible for melioidosis, which causes a clinical spectrum ranging from pneumonia and/or cutaneous infection to disseminated disease with fulminant septicaemia. Incident cases peak after monsoonal rains, particularly in individuals with immune dysfunction. Early diagnosis of melioidosis is challenging for clinicians, given its ability to mimic many other diseases and high clinical (associated mortality) impact. OBJECTIVES: The aim of this paper is to provide general practitioners with an overview of melioidosis, covering epidemiology, risk factors for infection, clinical disease spectrum, diagnostic techniques and an approach to management, including public health aspects. DISCUSSION: Primary care physicians play a key role in early disease recognition, initial patient stabilisation, request of appropriate clinical samples (particularly blood cultures) and prompt commencement of efficacious antibiotics. Patient education is paramount during high-risk periods, chiefly for patients with diabetes and/or those who engage in hazardous alcohol use, living in endemic areas of Australia.
BACKGROUND: Endemic to soils of Northern Australia, Burkholderia pseudomallei is the Gram-negative pathogen responsible for melioidosis, which causes a clinical spectrum ranging from pneumonia and/or cutaneous infection to disseminated disease with fulminant septicaemia. Incident cases peak after monsoonal rains, particularly in individuals with immune dysfunction. Early diagnosis of melioidosis is challenging for clinicians, given its ability to mimic many other diseases and high clinical (associated mortality) impact. OBJECTIVES: The aim of this paper is to provide general practitioners with an overview of melioidosis, covering epidemiology, risk factors for infection, clinical disease spectrum, diagnostic techniques and an approach to management, including public health aspects. DISCUSSION: Primary care physicians play a key role in early disease recognition, initial patient stabilisation, request of appropriate clinical samples (particularly blood cultures) and prompt commencement of efficacious antibiotics. Patient education is paramount during high-risk periods, chiefly for patients with diabetes and/or those who engage in hazardous alcohol use, living in endemic areas of Australia.
Authors: Courtney M Dewart; Francisco A Almeida; Christine Koval; Scott Nowicki; Jay E Gee; Mindy Glass Elrod; Christopher A Gulvik; Johanna S Salzer; Sietske de Fijter; Lindy Liu Journal: Emerg Infect Dis Date: 2021-12 Impact factor: 6.883