2024-02-05 13:16:44
Australia has had to raise an urgent health alert in recent days by declaring the death of two people from melioidosis. The contagion has spread to 28 more people, so the Health Department has been forced to warn the population of this increase in cases. The bacterial infection is usually caused by water contamination and comes at a time when Australia has experienced a severe storm of rain and flooding. This is not the first time that cases of the disease caused by the gram-negative bacteria burkholderia have been recorded. Although it usually occurs in tropical territory, there are studies that identify possible importation to Spain.
What is melioidosis?
Melioidosis is an infectious disease caused by the bacteria Burkholderia pseudomallei, which is Gram-negative and is commonly found in soil and surface waters. This bacteria is especially prevalent in rice fields, although it is not exclusively limited to this environment, and can infect people who come into contact with it in various locations.
The Burkholderia pseudomallei bacteria can enter the body through cuts in the skin, inhalation, or ingestion of contaminated water or soil. Melioidosis can occur in various forms, from skin infections to more serious forms that affect internal organs such as the lungs or liver. Furthermore, it is not transmitted from person to person or by zoonoses (between different animal species).
There are those who may be more predisposed to being infected by this bacteria, that is, according to the MSD Manual, there are some risk factors that are:
- Diabetes.
- Alcohol use disorder.
- Chronic kidney disease.
- Immunodeficiency that includes AIDS.
Although the mortality rate from melioidosis is generally estimated at 10%, there are occasions in which the infection can be lethal when there is a serious condition such as acute septicemic melioidosis.
What are the symptoms it causes?
Due to the diversity of the infection, as it can infect different organs, its symptoms can be very varied. The problem with melioidosis is that it can sometimes be misdiagnosed, as it produces symptoms similar to other pathologies.
For example, if it manifests as an acute lung infection, the variability of symptoms ranges from a mild condition to aggressive necrotizing pneumonia. Symptoms include anorexia, headaches, chest pain, generalized myalgia, fever, cough, tachypnea, bloody sputum, and the presence of nodular lesions in the lungs.
On the other hand, in its variant of acute septicemic infection, the most fatal, the symptoms manifest as septic shock with multisystem involvement. These include disorientation, respiratory distress, headache, throat swelling, abdominal cramps, diarrhea, pustular lesions, high fever, hypotension, and meningitis.
Finally, it can manifest as a localized infection with suppuration in any area of the body, generally in the form of an abscess and in the region of inoculation.
This is the treatment of melioidosis
Sometimes, melioidosis infection can happen like other infections happen, completely asymptomatic. In that sense, treatment is not necessary, since the immune system will completely eliminate the infection. But as mentioned, there are other situations in which melioidosis can become lethal. In the mildest pathology, the treatment is based on antibiotics. The medical team usually prescribes the following drugs: ceftacidime, imipenem, meropedem, piperacillin, trimethoprim, sulfamethoxazole and doxycillin.
However, if the infection becomes serious and the body begins to suffer from pneumonia or septicemia, beyond the symptom relief medications themselves, it may be necessary to use life supports adapted to each patient’s specific case.
References
Bush , LM , & Vazquez-Pertejo , MT (2023, November 15). Melioidosis. Manual MSD version for professionals. https://www.msdmanuals.com/es-es/professional/enfermedades-infecciosas/bacilos-gramnegativos/melioidosis
Guzman-Gomez , LP , Bilbao , MA , Peiro-Callizo , E. , & Salas , C. (2015). Melioidosis imported from Colombia to Spain. Infectious Diseases and Clinical Microbiology, 33(3), 214-216. https://doi.org/10.1016/j.eimc.2014.06.003
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