Journal ArticleDOI
Melioidosis: acute and chronic disease, relapse and re-activation
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TLDR
In melioidosis-endemic regions the importance of re-activation of Burkholderia pseudomallei from latent foci remains unclear and initial intensive therapy with ceftazidime or meropenem for at least 14 days, eradication therapy with trimethoprim-sulphamethoxazole monotherapy for at at least 3 months had been more successful.Abstract:
In melioidosis-endemic regions the importance of re-activation of Burkholderia pseudomallei from latent foci remains unclear. This topic was assessed in a 10-year prospective study (1989-99) of melioidosis in the tropical north of the Northern Territory of Australia, together with other aspects of the nature of melioidosis. Incubation period from defined inoculating events was previously ascertained as 1-21 (mean 9) days. Of 252 total cases 244 (97%) were considered to be from recent acquisition of B. pseudomallei infection and 8 (3%) were considered to be re-activation from a latent focus. Acute illness occurred in 222 (88%) cases; 30 (12%) cases had chronic illness (symptomatic for > 2 months). Of the 207 patients surviving the initial illness, 27 (13%) had a confirmed relapse (mean time from initial diagnosis of 8 months), with 5 relapsing twice. Of these 32 relapses, 15 (3 fatal) were associated with poor adherence to the eradication therapy antibiotics and 10 (none fatal) were failures of eradication with doxycycline monotherapy. Following initial intensive therapy with ceftazidime or meropenem for at least 14 days, eradication therapy with trimethoprim-sulphamethoxazole monotherapy for at least 3 months had been more successful.read more
Citations
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Journal ArticleDOI
Melioidosis: Epidemiology, Pathophysiology, and Management
TL;DR: Melioidosis is a disease of public health importance in southeast Asia and northern Australia that is associated with high case-fatality rates in animals and humans, and the role of preventative measures, earlier clinical identification, and better management of severe sepsis are required to reduce the burden of this disease.
Journal ArticleDOI
The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study.
TL;DR: Melioidosis should be seen as an opportunistic infection that is unlikely to kill a healthy person, provided infection is diagnosed early and resources are available to provide appropriate antibiotics and critical care.
Journal ArticleDOI
Medical progress: Melioidosis
Journal ArticleDOI
An Inv/Mxi-Spa-like type III protein secretion system in Burkholderia pseudomallei modulates intracellular behaviour of the pathogen.
Mark P. Stevens,Michael W. Wood,Lowrie A. Taylor,Paul Monaghan,Pippa Hawes,Philip W. Jones,Timothy S. Wallis,Edouard E. Galyov +7 more
TL;DR: Findings indicate that the Bsa type III secretion system plays an essential role in modulating the intracellular behaviour of B. pseudomallei.
Journal ArticleDOI
Melioidosis: Evolving Concepts in Epidemiology, Pathogenesis, and Treatment
TL;DR: While biothreat research is directed toward potential aerosol exposure to B. pseudomallei, the overall proportion of melioidosis cases resulting from inhalation rather than from percutaneous inoculation remains entirely uncertain, although the epidemiology supports a shift to inhalation during severe weather events such as cyclones and typhoons.
References
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Journal ArticleDOI
Melioidosis: A Major Cause of Community-Acquired Septicemia in Northeastern Thailand
Wipada Chaowagul,Nicholas J. White,David A. B. Dance,Yupaporn Wattanagoon,Pimjai Naigowit,Timothy M. E. Davis,Sornchai Looareesuwan,Nirun Pitakwatchara +7 more
TL;DR: In a prospective study of all patients with Pseudomonas pseudomallei infections admitted to a large provincial hospital in northeastern Thailand, 63 cases of septicemic melioidosis and 206 patients with other community-acquired septicemias were documented during a 1-y period as mentioned in this paper.
Melioidosis: A Major Cause of Community-Acquired Septicemia in
Northeastern Thailand,Wipada Chaowagul,Nicholas J. White,David A. B. Dance,Yupaporn Wattanagoon,Pimjai Naigowit,Timothy M. E. Davis,Sornchai Looareesuwan,Nirun Pitakwatchara +8 more
TL;DR: Septicemic melioidosis presented mainly in the rainy season, occurred predominantly in rice farmers or their families, and was significantly associated with preexisting diabetes mellitus or renal failure, and the mortality was high.
Journal ArticleDOI
Melioidosis: Review and Update
TL;DR: Melioidosis prevails in Southeast Asia and northern Australia and is reported from countries located between 20 degrees north latitude and 20 degrees south latitude as well as in travelers and in soldiers who have resided in these areas.
Journal ArticleDOI
Melioidosis: the tip of the iceberg?
TL;DR: Clinical melioidosis is now known to be an important cause of human morbidity and mortality in Thailand, and this may be true throughout Southeast Asia, which is usually regarded as the main endemic area for the disease.
Journal ArticleDOI
Halving of mortality of severe melioidosis by ceftazidime
Nicholas J. White,Wipada Chaowagul,V. Wuthiekanun,David A. B. Dance,David A. B. Dance,Yupaporn Wattanagoon,Nirun Pitakwatchara +6 more
TL;DR: Ceftazidime treatment was associated with a 50% (95% CI 19-81%) lower overall mortality than conventional treatment and should now become the treatment of choice for severe melioidosis.
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