ABSTRACT
Pneumonia is the most common presentation of melioidosis. Culture blood or tissue fluid is the mainstay for the diagnosis. Patients with rapidly progressing pneumonia and bacteraemia require intensive care unit (ICU) management. The mortality can be up to 50% in patients with acute fulminant melioidosis, even with treatment. Despite the modern diagnostic system, Burkholderia pseudomallei is often misidentified as Pseudomonas or other bacteria of Burkholderia species. Early diagnosis and appropriate intravenous antibiotics like meropenem or ceftazidime with adequate dose and duration are the mainstay of management. The non-pulmonary organ infection like neurologic, prostatic, bone, joint, cutaneous, and soft-tissue melioidosis are common. With high-quality ICU and supportive comorbidity care, the general mortality of melioidosis can be reduced to less than 10%. An eradication therapy of co-trimoxazole oral antibiotics for 4 months is required to prevent relapse.
