Melioidosis is caused by Burkholderia pseudomallei, a saprophyte found in soil and water (rice paddy fields). Infection is by inoculation or inhalation, leading to bacteraemia, which is followed by the formation of abscesses in the lungs, liver and spleen. Patients with diabetes, renal stones, thalassaemia or severe burns are particularly susceptible. The disease is most common in South India, East Asia and northern Australia, and carries a significant mortality. Disease may present many years or decades after the initial exposure.
There is high fever, prostration and sometimes diarrhoea, with signs of pneumonia and enlargement of the liver and spleen. The chest X-ray resembles that of acute caseous tuberculosis. In more chronic forms, multiple abscesses occur in subcutaneous tissue and bone, and profound wasting is a major problem.
INVESTIGATIONS AND MANAGEMENT: -
Culture of blood, sputum or pus may yield B. pseudomallei. Indirect haemagglutination testing can be helpful in travellers; however, most people in endemic areas are seropositive.
HOMEOPATHIC MANAGEMENT: -
The medicines that can be thought of use are:-
- Hepar sulphur
- Calcarea sulph
- Merc sol.