Clinical presentation of the disease varies on a case by case basis. The following characteristics are typical of melioidosis.
- An acute or chronic localized infection which may or may not include symptoms of fever and muscle aches. Such infection often results in ulcer, nodule, or skin abscess.
- An acute pulmonary infection with symptoms of high fever, headache, chest pain, anorexia, and general muscle soreness.
- A bloodstream infection with symptoms of fever, headache, respiratory distress, abdominal discomfort, joint pain, muscle tenderness, and/or disorientation.
- A disseminated infection with symptoms of fever, weight loss, stomach or chest pain, muscle or joint pain, and/or headache or seizure. Abscesses in the liver, lung, spleen, and prostate are often observed in patients diagnosed with disseminated infections; less frequently, brain abscesses may be seen.
Laboratory Criteria For Diagnosis
- Isolation of B. pseudomallei from a clinical specimen of a case of severe febrile illness: Culture of the organism may be done by blood, sputum, urine, pus, throat swab, or swabs from organ abscesses or wounds.
- Evidence of a fourfold or greater rise in B. pseudomallei antibody titer by IHA between acute- and convalescent-phase serum specimens obtained greater than or equal to 2 weeks apart.
- Evidence of B. pseudomallei DNA (for example, by LRN-validated polymerase chain reaction) in a clinical specimens collected from a normally sterile site (blood) or lesion of other affected tissue (abscesses, wound).
A case that meets the clinical case definition, one or more of the probable lab criteria, and one of the following epidemiologic findings:
- History of travel to a melioidosis-endemic region, OR
- Known exposure to B. pseudomallei as a result of intentional release or occupational risk (lab exposure).