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Melioidosis : an important cause of pneumonia in residents of and travellers returned from endemic regions

Currie, Bart J. (2003). Melioidosis : an important cause of pneumonia in residents of and travellers returned from endemic regions. European Respiratory Journal,22(3):542-550.

Document type: Journal Article
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Title Melioidosis : an important cause of pneumonia in residents of and travellers returned from endemic regions
Author Currie, Bart J.
Journal Name European Respiratory Journal
Publication Date 2003
Volume Number 22
Issue Number 3
ISSN 1399-3003   (check CDU catalogue open catalogue search in new window)
Start Page 542
End Page 550
Total Pages 9
Place of Publication Switzerland
Publisher European Respiratory Society
Language English
HERDC Category C1 - Journal Article (DEST)
Abstract Melioidosis is endemic in South East Asia, Asia and northern Australia. Infection usually follows percutaneous inoculation or inhalation of the causative bacterium, Burkholderia pseudomallei, which is present in soil and surface water in the endemic region. While 20-36% of melioidosis cases have no evident predisposing risk factor, the vast majority of fatal cases have an identified risk factor, the most important of which are diabetes, alcoholism and chronic renal disease. Half of all cases present with pneumonia, but there is great clinical diversity, from localised skin ulcers or abscesses without systemic illness to fulminant septic shock with multiple abscesses in the lungs, liver, spleen and kidneys. At least 10% of cases present with a chronic respiratory illness (sick >2 months) mimicking tuberculosis and often with upper lobe infiltrates andlor cavities on chest radiography. As with tuberculosis, latency with reactivation decades after infection can also occur, although this is rare. Confirmation of diagnosis is by culture of B. pseudomallei from blood, sputum, throat swab or other samples. Microbiology laboratories need to be informed of the possibility of melioidosis, as those not familiar with it can misidentify the organism. Antibiotic therapy is initial intensive therapy with i.v. ceftazidime or meropenem or imipenem +/-cotrimoxazole for ≥ 10 days, followed by eradication therapy with cotrimoxazole +/-doxycycline +/- chloramphenicol (first 4 weeks only) for ≥3 months. Melioidosis has been increasingly recognised in returning travellers in Europe and recently melioidosis and colonisation with B. pseudomallei have been documented in cystic fibrosis patients visiting or resident in endemic areas.
Keywords endemic
melioidosis
Pneumonia
DOI http://dx.doi.org/10.1183/09031936.03.00006203   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
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Created: Mon, 17 Dec 2007, 09:02:11 CST