Background
- Causes glanders (also known as equinia, malleus, droes, and farcy)
Microbiology
- Gram-negative bacillus
- Oxidase variable
Epidemiology
Clinical Manifestations
- Acquired primarily from horses
- Incubation period ranges from 1 to 14 days, though in chronic infections it can be up to several months
- Typically starts with localized infection at site of inoculation (skin within a few days, or lungs within 1-2 weeks)
- Low-grade fevers, malaise, fatigue, headache, myalgias including back ache, lymphadenopathy and chest pain
- Natural history may have a biphasic clinical course, with initial improvement followed by worsening and death
- Most often characterized by ulcerating lesions of the skin and mucosal surfaces
- If disseminated, can appear anywhere
- Pain and swelling, developing into an ulcer that can become hemorrhagic
- Can present with nodular lymphangitis
- Pneumonic form presents with pneumonia, lung abscesses, empyema, and pleural effusions
- When it disseminates, it can cause abscesses in multiple organs (lungs, liver, spleen)
Management
Further Reading
