Melioidosis

Navigation Menu

General issues of Vaccine
Cold chain Correlates of Protection Vaccines for Asplenia Vaccines for Pregnant women Vaccines for Immunocompromised hosts Vaccine hesitancy Additional materials of vaccine

General issues of Tropical med.

Definition of Tropical Medicine Matrices of tropical infection General issues of Helminths Neglected Tropical Diseases Sexually-transmitted infections Non-Communicable Diseases Maternal health and contraception Child health Malnutrition and Micronutrient Eosinophilia Fever in the tropics Diarrhea in the tropics Anemia in the tropics Dermatology in the tropics Ophthalmology in the tropics Neurology in the tropics Mental health in the tropics Surgery in the tropics Humanitarian emergency Epidemiology in outbreak Antimicrobial resistance Pathology of infectious diseases

General issues of Travel med.
Epidemiology of Travel health Last minute traveler Time zone issue High altitude medicine Diving medicine Pregnancy and travel Children and travel Elderly and travel

Immunology
Principle of human immune system Innate immunity Cellular immunity Humoral immunity Neutralizing antibody and its assay Antigenic Cartography Additional materials of immunology

Epi & Stats
Basics & Definition Epidemiology Odds in statistics and Odds in a horse race Collider bias Data distribution Statistical test Regression model Multivariate analysis Marginal effects Prediction and decision Table-related commands in STATA Missing data and imputation

Virus
HIV HIV-TB co-infection HIV-STI interaction Viral Hemorrhagic Fever Ebola Crimean-Congo hemorrhagic fever SFTS Rabies Polio Dengue Yellow fever Chikungunya Zika Japanese encephalitis Tick-borne encephalitis Viral hepatitis Measles Smallpox and Monkeypox Respiratory Syncytial virus

COVID-19
Bivalent BA.1/BA.4-5 mRNA vaccines Monovalent XBB-1.5 mRNA vaccine Private archives of the initial phase of the pandemic Private archives of lecture materials of COVID vaccine as of March 2021 厚生労働省が発出する保健行政関連の文書の読み解き方

Bacteria
Bacteriological tests Tuberculosis Tuberculosis in Children HIV-TB co-infection Leprosy Dermatological mycobacterium infecions Syphilis and Yaws Plague Pneumococcus Meningococcus Typhoid Salmonellosis Melioidosis Leptospirosis Brucellosis Bartonellosis Lyme disease and Relapsing fever Tularaemia Tetanus Diphtheria Anthrax Coxiellosis

Rickettsia
Rickettsiosis Scrub typhus Spotted fevers Epidemic typhus Murine typhus

Protozoa
Overview of protozoa Overview of medicine for protozoa Malaria Chagas disease African trypanosomiasis Leishmaniasis Trichomoniasis Toxoplasmosis Amoebiasis Giardiasis Cryptosporidiosis Cyclosporiasis Isosporiasis Pentatrichomoniasis Microsporidiasis Babesiosis

Fungi
General issues of fungi Coccidioidomycosis Paracoccidioidomycosis Histoplasmosis Talaromycosis Blastomycosis Sporotrichosis

Nematode (roundworm)
Nematode principles Lympatic filariasis Onchocerciasis Loiasis Microscopic differentiation of microfilariae Strongyloidiasis Ascariasis Ancylostomiasis (hookworm) Trichuriasis (whipworm) Enterobiasis (pinworm) Angiostrongyliasis (rat lungworm) Dracunculiasis (Guinea worm) Anisakiasis Trichinellosis (Trichinosis) Gnathostomiasis Spirurinasis Soil-transmitted helminths

Trematode (fluke, distoma)
General issues of Helminths Trematode principles Schistosomiasis Clonorchiasis Fascioliasis Paragonimiasis Metagonimiasis

Cestode (tapeworm)
General issues of Helminths Cestode principles Diphyllobothriasis Sparganosis Taeniasis Echinococcosis

Medical Zoology
Zoonosis Insectology Mosquitology Acarology Batology Snake toxicology Scorpion and spider toxicology Marine toxicology

pathogen

• Burkholderia pseudomallei
• potential biological weapon

epidemiology

• endemic South Asia, Southeastern Asia and Australia
  • especially in Northeastern Thailand and Northern Australia
  • Third ID death in Northeaster Thailand following after HIV and TB
• reason of localized distributions are unknown
• highly seasonal, most in rainy season
  • stormy weather events like typhoon

transmission

• Burkholderia pseudomallei lives in soil and water
• close and repetitive contact to soil and freshwater, especially occupationally
  • rice farmers in Thailand, Aboriginals in Australia
• most of cases unclear contact history
• immersion in freshwater or aspiration of freshwater like in tsunami may cause infection
• outbreak case mediated by contaminated water supply, disinfectant or detergents

incubation period

• 1-21 days after apparent exposure
  • mean 9 days
• rarely long latency
  • a case of 62 years after exposed in Viet Nam
    • "Vietnamese time-bomb"

risk factors

• 60-90% of cases have underlying conditions
• especially diabetes mellitus and chronic renal failure
  • steroid, alcohol abuse, liver dysfunction, chronic lung disease, etc.

clinical course

• peak in 40-60 y/o
• male > female, presumably difference of exposure activity
• most asymptomatic or mild non-specific
  • 60-70% of endemic area population show seroconversion until 4 y/o
• apparent case shows sepsis with fever and rigor
  • 80% of apparent cases have pneumonia
    • widespread consolidations or cavitations
      • mimics TB
• altered mental status
• jaundice
• diarrhea
• widespread metastatic abscesses
  • liver, spleen, parotid gland, prostate in male, cutaneous, subcutaneous, keratitis
  • parotid abscess common in children in Thailand
  • hepatosplenic abscess common in Thailand
  • prostatic abscess common in Australia

diagnosis

• Culture only
  • oxidase positive gram negative rods resistant to aminoglycosides but susceptible to co-amoxiclav should be assumed as B. pseudomallei until proven otherwise
• serological or molecular test have low sensitivity and low specificity
• unevenly stained gram negative bipolar bacilli