Disease, Whitmore's

An infectious illness, also called melioidosis, that is most frequent in Southeast Asia and Northern Australia and is caused by a bacteria called "Pseudomonas pseudomallei" found in soil, rice paddies and stagnant waters. Humans catch the disease by inhalation of contaminated dust or when soil contaminated by the bacteria comes in contact with abraded (scraped) skin. Melioidosis most commonly involves the lungs where the infection can form a cavity of pus (abscess). The bacteria can also spread from the skin through the bloodstream the brain, eyes, heart, liver, kidneys, and joints. The common symptoms of melioidosis are not specific. They include headaches, fever, chills, cough, chest pain, and loss of appetite. Melioidosis can also cause encephalitis (brain inflammation) with seizures (convulsions). The diagnosis is by a microscopic evaluation of a sputum (spit) sample in the laboratory. A blood test may detect early acute cases of melioidosis. The treatment of melioidosis involves antibiotics and depends on the location of the disease: Mild illness: Antibiotics such as chloramphenicol, doxycycline, sulfisoxazole, or trimethoprim-sulfamethoxazole. More severe illness: A combination of chloramphenicol, doxycycline, and co-trimoxazole. Very severe illness (as with persistent blood infection): Intravenous antibiotics including chloramphenicol. If sputum cultures remain positive for 6 months: Surgical removal of the lung abscess with lobectomy is considered. Antibiotic treatments may be necessary from 3 to 12 months. Melioidosis can remain latent (in hiding) for years and emerge when a person's resistance is low. The name, Whitmore's disease, is in honor of Major Alfred Whitmore (1876-1946), an English surgeon in India.