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Melioidosis is a potentially life-threatening bacterial infection caused by Burkholderia pseudomallei, a bacterium naturally present in wet soil and surface water in tropical and subtropical climates. It primarily affects individuals living or working in regions such as Southeast Asia and Northern Australia, with Malaysia, Singapore, and Thailand being notable hotspots. The bacteria can enter the human body through cuts and abrasions, inhalation of contaminated dust, or consumption of tainted water. Occupations that involve close contact with soil or stagnant water—such as farming, construction, and landscaping—carry higher exposure risks.
Global travel and changing climate patterns have also contributed to the increasing detection of melioidosis in regions outside its traditional geographic range.
Recognising the Symptoms of Melioidosis
Melioidosis can affect multiple organ systems, and symptoms may vary depending on the route of infection and the individual’s health status. Early identification and prompt medical attention are critical to preventing severe complications.
General Symptoms
The illness often begins with non-specific signs resembling influenza. Fever is usually the first and most persistent symptom, frequently accompanied by chills, muscle aches, headache, and unintentional weight loss. These generalised symptoms reflect the body’s immune response and may precede more localised or serious complications.
Respiratory Involvement
Pulmonary melioidosis can present with a range of respiratory symptoms, from a persistent cough (which may be dry or produce phlegm or blood) to shortness of breath and chest pain. In more serious cases, the condition can lead to pneumonia or acute respiratory distress, particularly in individuals with chronic lung disease or weakened immune systems.
Skin and Soft Tissue Infections
Entry of the bacterium through broken skin can result in localised skin infections. These may manifest as ulcers or abscesses that ooze pus. Such symptoms, although superficial, may indicate deeper internal involvement. Subcutaneous abscesses are frequently observed in individuals with repeated exposure to contaminated soil or water.
Neurological Effects
In advanced cases, the infection may reach the central nervous system. This may cause symptoms such as disorientation, confusion, or seizures. These neurological signs often suggest bloodstream infection or widespread dissemination of the bacteria and warrant immediate hospital care.
Systemic Spread and Other Manifestations
Melioidosis is capable of affecting various systems in the body. Joint pain and swelling may arise if the infection spreads to the bones or joints. Some men may encounter urinary difficulties, indicating potential involvement of the urogenital tract. Internal abscesses may also lead to abdominal or chest pain. When the infection becomes disseminated, multiple organs may be impacted, requiring an extended course of treatment and close clinical monitoring.
Treatment Options for Melioidosis
Managing melioidosis involves an intensive, two-phase antibiotic regimen. Delays in treatment can result in severe illness or death, making early diagnosis and prompt therapy essential
Ceftazidime:
is typically the first-line intravenous antibiotic for acute cases.
Carbapenems:
Medications such as meropenem or imipenem are employed in more severe or resistant infections.
Trimethoprim-Sulfamethoxazole (TMP-SMX):
Used in the second, oral phase of treatment once the acute infection has stabilised.
Doxycycline:
An alternative for patients who cannot tolerate TMP-SMX.
Amoxicillin-Clavulanic Acid (Co-Amoxiclav):
Preferred for use in children and pregnant women due to its favourable safety profile.
Frequently Asked Questions About Melioidosis
1. Is melioidosis contagious?
No. The infection is not typically transmitted between individuals. It is acquired through environmental exposure.
2. How is it diagnosed?
Diagnosis requires laboratory testing, such as blood cultures or tissue biopsies. Due to its wide-ranging symptoms, accurate identification is crucial for effective treatment.
3. Can it be fatal?
Yes. Without appropriate medical intervention, melioidosis can lead to severe complications and death. Early treatment greatly improves prognosis.
4. Who is most at risk?
Individuals with diabetes, chronic kidney disease, or weakened immune systems are particularly vulnerable. Those frequently exposed to contaminated soil or water in endemic areas are also at elevated risk.
5. How can melioidosis be prevented?
Preventive measures include wearing protective clothing during outdoor activities, avoiding contact with muddy water, and ensuring access to safe drinking water in affected regions.
Book an Appointment at Gleneagles Hospitals
Melioidosis is a serious yet under-recognised bacterial infection that can rapidly escalate if left untreated. With symptoms that mimic other conditions and the potential for multi-organ involvement, medical evaluation is essential for accurate diagnosis and timely treatment.
If you suspect you may be at risk or are experiencing any related symptoms, consult a healthcare professional promptly. You may book an appointment at Gleneagles Hospitals through our website or via the MyHealth360 mobile application, available on the Google Play Store and Apple App Store.
Your health and peace of mind are our priority. Let our experienced medical team support you towards a safe and full recovery.
