Burkholderia pseudomallei - Revision history

Aidan at 15:49, 5 February 2026

2026-02-05T15:49:56Z

Aidan: /* Background */

2026-02-05T15:33:24Z

Background

← Older revision		Revision as of 15:33, 5 February 2026
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	*Oxidase [[Oxidase::positive]], indole [[Indole::negative]] [[Stain::Gram-negative]] [[Shape::bacillus]] with "'''safety pin'''" appearance (i.e. bipolar staining)		*Oxidase [[Oxidase::positive]], indole [[Indole::negative]] [[Stain::Gram-negative]] [[Shape::bacillus]] with "'''safety pin'''" appearance (i.e. bipolar staining)
	*[[Hemolysis pattern::Non-hemolytic]]		*[[Hemolysis pattern::non-hemolytic\|Non-hemolytic]]
	*Colonies start small, smooth, cream-coloured with a metallic sheen, but become dry and wrinkly after 1 to 2 days of incubation		*Colonies start small, smooth, cream-coloured with a metallic sheen, but become dry and wrinkly after 1 to 2 days of incubation
	*Inherently resistant to [[Polymixin\|polymixins]]		*Inherently resistant to [[Polymixin\|polymixins]]

Aidan: Text replacement - "[[Hemolysis::" to "[[Hemolysis pattern::"

2026-01-27T15:19:48Z

Text replacement - "[[Hemolysis::" to "[[Hemolysis pattern::"

← Older revision		Revision as of 15:19, 27 January 2026
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	*Oxidase [[Oxidase::positive]], indole [[Indole::negative]] [[Stain::Gram-negative]] [[Shape::bacillus]] with "'''safety pin'''" appearance (i.e. bipolar staining)		*Oxidase [[Oxidase::positive]], indole [[Indole::negative]] [[Stain::Gram-negative]] [[Shape::bacillus]] with "'''safety pin'''" appearance (i.e. bipolar staining)
	*[[Hemolysis::Non-hemolytic]]		*[[Hemolysis pattern::Non-hemolytic]]
	*Colonies start small, smooth, cream-coloured with a metallic sheen, but become dry and wrinkly after 1 to 2 days of incubation		*Colonies start small, smooth, cream-coloured with a metallic sheen, but become dry and wrinkly after 1 to 2 days of incubation
	*Inherently resistant to [[Polymixin\|polymixins]]		*Inherently resistant to [[Polymixin\|polymixins]]

Aidan: /* Clinical Manifestations */

2021-05-25T13:36:40Z

Clinical Manifestations

← Older revision		Revision as of 13:36, 25 May 2021
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	*Incubation period [[Usual incubation period::9 days]] (range [[Incubation period range::1 to 21 days]])		*Incubation period [[Usual incubation period::9 days]] (range [[Incubation period range::1 to 21 days]])
	*Presentations can vary from asymptomatic, skin ulcers, abscesses, latent infection, chronic pneumonia (similar to TB), or fulminant shock[[CiteRef::diemert2010th]]		*Presentations can vary from asymptomatic, skin ulcers, abscesses, latent infection, chronic pneumonia (similar to TB), or fulminant shock[[CiteRef::diemert2010th]][[CiteRef::meumann2011cl]]
	**[[Pneumonia]] (50%)		**[[Pneumonia]] (50%)
	**Genitourinary infection (15%)		**Genitourinary infection (15%)

Aidan: Text replacement - "[[Has cell shape::" to "[[Shape::"

2020-10-08T15:12:31Z

Text replacement - "[[Has cell shape::" to "[[Shape::"

← Older revision		Revision as of 15:12, 8 October 2020
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	===Microbiology===		===Microbiology===

	*Oxidase [[Oxidase::positive]], indole [[Indole::negative]] [[Stain::Gram-negative]] [[~~Has cell shape~~::bacillus]] with "'''safety pin'''" appearance (i.e. bipolar staining)		*Oxidase [[Oxidase::positive]], indole [[Indole::negative]] [[Stain::Gram-negative]] [[Shape::bacillus]] with "'''safety pin'''" appearance (i.e. bipolar staining)
	*[[Hemolysis::Non-hemolytic]]		*[[Hemolysis::Non-hemolytic]]
	*Colonies start small, smooth, cream-coloured with a metallic sheen, but become dry and wrinkly after 1 to 2 days of incubation		*Colonies start small, smooth, cream-coloured with a metallic sheen, but become dry and wrinkly after 1 to 2 days of incubation

Aidan: /* Laboratory Safety */

2020-09-20T18:30:58Z

Laboratory Safety

← Older revision		Revision as of 18:30, 20 September 2020
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	*[[Biosafety risk groups\|Biosafety risk group 3]]		*[[Biosafety risk groups\|Biosafety risk group 3]]
	*Lab workers can have aerosol exposure		*Lab workers can have aerosol exposure if aerosol-generating procedure done outside of a BSC, bite/scratch from infected lab animals, or needlestick/percutaneous exposure
			**Those at higher risk include: not wearing proper PPE, [[diabetes]], [[chronic liver disease]], [[chronic kidney disease]], [[Alcohol use disorder\|alcohol abuse]], chronic [[Corticosteroids\|corticosteroid]] use, [[hematologic malignancy]], [[neutropenia]] or neutrophil dysfunction, [[chronic lung disease]], [[thalassemia]], or other [[immunosuppression]]
	*May need prophylaxis in high-risk patients		*May need prophylaxis in high-risk patients
	**[[TMP-SMX]] or [[doxycycline]] or [[amoxicillin-clavulanic acid]]		**[[TMP-SMX]] or [[doxycycline]] or [[amoxicillin-clavulanic acid]]
			**[[TMP-SMX]] DS 2 tablets (>60 kg) or SS 3 tablets (40-60 kg) or DS 1 tablet (<40 kg) PO bid
			**[[Amoxicillin-clavulanic acid]] 20/5 mg/kg/dose PO tid
			**Duration: 21 days
	*Monitor with serology at baseline, weeks 1 2 4 and 6 post-exposure		*Monitor with serology at baseline, weeks 1 2 4 and 6 post-exposure
	**Needs to be sent to CDC via NML		**Needs to be sent to CDC via NML

Aidan: /* Laboratory Safety */

2020-09-03T15:16:38Z

Laboratory Safety

← Older revision		Revision as of 15:16, 3 September 2020
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	===Laboratory Safety===		===Laboratory Safety===

			*[[Biosafety risk groups\|Biosafety risk group 3]]
	*Lab workers can have aerosol exposure		*Lab workers can have aerosol exposure
	*May need prophylaxis in high-risk patients		*May need prophylaxis in high-risk patients

Aidan: /* Prevention */

2020-09-03T15:16:17Z

Prevention

← Older revision		Revision as of 15:16, 3 September 2020
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	==Prevention==		==Prevention==

	===~~Biosafety~~===		===Laboratory Safety===

	*Lab workers can have aerosol exposure		*Lab workers can have aerosol exposure

Aidan: /* Diagnosis */

2020-08-29T11:00:04Z

Diagnosis

← Older revision		Revision as of 11:00, 29 August 2020
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	*Can occasionally lay latent and reactivate decades after exposure		*Can occasionally lay latent and reactivate decades after exposure

	=== Prognosis and Complications ===		===Prognosis and Complications===

	*50% mortality even with high-quality care		*50% mortality even with high-quality care
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	**Blood, throat, and urine cultures should be taken from ''all'' patients with suspected melioidosis		**Blood, throat, and urine cultures should be taken from ''all'' patients with suspected melioidosis
	**Grows on blood agar, MacConkey, etc. (i.e. ''not'' a fastidious organism)		**Grows on blood agar, MacConkey, etc. (i.e. ''not'' a fastidious organism)
	**Can use selective colistin or polymyxin B		**Can use selective colistin or polymyxin B, since it is inherently resistant
	**On sheep blood agar, grows as small, smooth, cream-coloured colony with metallic sheen		**On sheep blood agar, grows as small, smooth, cream-coloured colony with metallic sheen
	**May develop a dry and '''wrinkled''' appearance after 1 to 2 days of incubation		**May develop a dry and '''wrinkled''' appearance after 1 to 2 days of incubation
			*MALDI-ToF may misidentify it as [[Burkholderia thailandensis]], and automated biochemical tests may misidentify it as [[Chromobacterium violaceum]]
	*MALDI-ToF is ''not'' reliable for identifying it
	*Other methods		*Other methods
	**PCR		**PCR

Aidan at 10:54, 29 August 2020

2020-08-29T10:54:02Z

← Older revision		Revision as of 10:54, 29 August 2020
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	==Background==		==Background==

	* Also called '''melioidosis''' or '''Whitmore's disease'''		*Also called '''melioidosis''' or '''Whitmore's disease'''

	===Microbiology===		===Microbiology===
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	**Neuro (3-5%)		**Neuro (3-5%)
	**Disseminated infections can involve liver, spleen, lung, and prostate		**Disseminated infections can involve liver, spleen, lung, and prostate
	*About 50% of clinical cases have bacteremia, and 20% of cases will develop septic shock		*About 50% of clinical cases have [[Causes::bacteremia]], and 20% of cases will develop [[Causes::septic shock]]
	*Can occasionally lay latent and reactivate decades after exposure		*Can occasionally lay latent and reactivate decades after exposure

			=== Prognosis and Complications ===

		⚫	*50% mortality even with high-quality care

	==Diagnosis==		==Diagnosis==
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	*Others: [[Is treated by::amoxicillin-clavulanic acid]]		*Others: [[Is treated by::amoxicillin-clavulanic acid]]

	==~~Biosafety~~==		==Prevention==

			===Biosafety===

	*Lab workers can have aerosol exposure		*Lab workers can have aerosol exposure
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	*Monitor with serology at baseline, weeks 1 2 4 and 6 post-exposure		*Monitor with serology at baseline, weeks 1 2 4 and 6 post-exposure
	**Needs to be sent to CDC via NML		**Needs to be sent to CDC via NML

	==Prognosis==

⚫	*50% mortality even with high-quality care
	{{DISPLAYTITLE:''Burkholderia pseudomallei''}}		{{DISPLAYTITLE:''Burkholderia pseudomallei''}}
	[[Category:Gram-negative bacilli]]		[[Category:Gram-negative bacilli]]

← Older revision		Revision as of 15:49, 5 February 2026
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	*Humans and animals		*Humans and animals
	*Important cause of death in south-east Asia and northern Australia		*Important cause of death in south-east Asia (Thailand, India, Malaysia, Cambodia, Vietnam, Nepal, Indonesia, Philippines, Bangladesh) and northern Australia
	**Up to 80% seroprevalence in Thailand, mostly asymptomatic		**Up to 80% seroprevalence in Thailand, mostly asymptomatic
	**More cases during the rainy season		**More cases during the rainy season
	**Sporadic cases elsewhere, including the Middle East, Africa, and the ~~Americas~~		**Sporadic cases elsewhere, including the Middle East, Africa (Nigeria), and the Caribbean (Panama)
	*May have latent disease with reactivation much later		*May have latent disease with reactivation much later
	*Acquired by percutaneous inoculation, inhalation (esp. lab workers), and ingestion		*Acquired by percutaneous inoculation, inhalation (esp. lab workers), and ingestion
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	*Monitor with serology at baseline, weeks 1 2 4 and 6 post-exposure		*Monitor with serology at baseline, weeks 1 2 4 and 6 post-exposure
	**Needs to be sent to CDC via NML		**Needs to be sent to CDC via NML

			== Further Reading ==

			* Travel-associated melioidosis: a narrative review. ''J Travel Med.'' 30(3):2023. doi: [https://doi.org/10.1093/jtm/taad039 10.1093/jtm/taad039]
	{{DISPLAYTITLE:''Burkholderia pseudomallei''}}		{{DISPLAYTITLE:''Burkholderia pseudomallei''}}
	[[Category:Gram-negative bacilli]]		[[Category:Gram-negative bacilli]]