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Melioidosis (Burkholderia pseudomallei)
2012 Case Definition

Clinical Description

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

Confirmed cases:

  • 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.
Probable:
  • 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).

Case Classification

Probable

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).

Confirmed

A case that is laboratory confirmed, with or without clinical evidence.

Comments

States and territories should also notify the CDC’s Bacterial Special Pathogens Branch of such cases by calling 404-639-1711 or emailing: bspb@cdc.gov.



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