BURKHOLDERIA
Burkholderia
pseudomallei is a saprophyte in soil, ponds, rice paddies and
vegetables lo-cated in Southeast Asia, the Philippines, Indonesia, and other
tropical areas. Infection is acquired by direct inoculation or by inhalation of
aerosols or dust containing the bacteria. The disease, melioidosis, is usually an acute pneumonia; however, it is
sufficiently vari-able that subacute, chronic, and even relapsing infections
may follow systemic spread. Some soldiers relapsed years after their return
from Vietnam. The clinical and radiologic features may resemble tuberculosis.
In fulminant cases, rapid respiratory failure may en-sue and metastatic
abscesses develop in the skin or other sites. Tetracycline, chloram-phenicol,
sulfonamides, and trimethoprim – sulfamethoxazole have been effective in
ther-apy. B. cepacia is an
opportunistic organism that has been found to contaminate reagents,
disinfectants, and medical devices in much the same manner as P. aeruginosa. It has also complicated
the course of CF but does not produce the mucoid colony type seen with P.aeruginosa.
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