Melioidosis
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Abstract
Melioidosis is a bacterial disease that affects humans and many species of animals. While some infections are subclinical, others result in localized acute or chronic disease, or fatal septicemia. Because it can affect almost any organ, melioidosis can mimic many other diseases; it is sometimes called “the great imitator.” Infections can also remain asymptomatic for months or years, and emerge to cause disease at a later time. A misdiagnosis may be fatal; the causative organism, Burkholderia pseudomallei, is susceptible to a limited number of antibiotics.
In endemic areas, melioidosis is an important cause of illness and death in humans and animals. Outside these regions, it can be a concern in travelers, immigrants and imported animals. In 1975, a panda is thought to have introduced melioidosis to the Paris Zoo, where it caused a severe outbreak. The epidemic spread to other zoos in Paris and Mulhouse, and to equestrian clubs throughout France. It decimated some zoo populations and caused at least two human deaths. More recently, melioidosis was reported in three pet iguanas in the U.S. and the Czech Republic, all of which had resided in a non-endemic region for more than a year. The importance of considering melioidosis among the diagnostic possibilities is highlighted by such reports, even outside areas of known endemicity. An additional concern about B. pseudomallei is that has been identified as a potential biological weapon.