"Melioidosis is a disease of the monsoon season in the tropics with a greatest prevalence in the northeastern provinces of Thailand and the 'Top End' of the Northern Territory and Queensland in Australia 6,9. It was previously thought to be confined to temperate zones, however increasing reports of locally acquired transmission in non-endemic regions suggest an expanding geographic boundary, potentially driven by adverse weather events related to climate change10."
"The English pathologist Alfred Whitmore (1876-1946) and the Indian bacteriologist C S Krishnaswami first described melioidosis in patients with opium addiction in Yangon, Burma in 1912 5,6. "
"Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei (previously known as Pseudomonas pseudomallei) and is a multisystem disorder which may affect the lungs, brain, visceral organs, or musculoskeletal system."
"kava (Piper methysticum) ingestion"
"The bacterium Burkholderia pseudomallei is a Gram negative bacillus and an environmental saprophyte that is found in soil and stagnant water 6,9. The organism can enter the body directly though cuts/wounds or be inhaled in dust 6,9. The organism survives within the cytoplasm of macrophages which ingest it 9, and it may thus remain dormant for many years 6."
"other disseminating infections that cause multifocal abscesses such as Staphylococcus aureus and Klebsiella pneumoniae, particularly as these also cause prostatic abscesses. Others include tuberculosis and entamoeba based on the fact that the lungs are the most commonly affected organ, and shared epidemiology, tuberculosis is the most significant differential diagnosis"
Expected headings
"Pulmonary manifestations"
"Acute"
"Subacute to chronic"
"Head and neck manifestations"
"Abdominal manifestations"
"Central nervous system manifestations"
"As many different organ systems can be affected, presentation is similarly variable, and patients may present with acute, subacute or chronic illness, each with different radiological findings."
"Melioidosis can also occur in the visceral organs of the abdomen, most commonly in the liver and spleen. Appearances can range from a large 'honeycomb' type abscess to a multitude of microabscesses. It can also occur, albeit far less commonly, in the pancreas, kidneys, adrenal glands, and even the prostate (higher incidence in Australia than elsewhere) 3,6,9."
"non-infective conditions which mimic abscesses (e.g. cavitating lung cancer, high grade gliomas)"