Human melioidosis: an emerging medical problem

  • C. J. Smith
  • J. C. Allen
  • M. Noor Embi
  • O. Othman
  • N. Razak
  • G. Ismail
Review Paper
Received:
Accepted:

Summary

Human melioidosis is endemic in South East Asia and tropical Australia. However, increasing numbers of case reports are coming from other parts of the world. Increasing world travel and the potential for person-to-person infection in non-endemic areas make the likelihood of physicians and medical microbiologists encountering the disease far greater than heretofore. Both the disease, melioidosis, and the causative organism,Pseudomonas pseudomallei, have unusual features which render them worthy of consideration. In this review, an overview is given of the microbiology ofPseudomonas pseudomallei. Original studies on the presence of fimbriae are presented and factors influencing pathogenicity of the organism discussed. Descriptions of the properties of the various ‘exotoxins’ are presented. Current veterinary and medical knowledge relating to the disease is outlined. Attention is drawn to those features—prolonged latency, multiplicity of presenting conditions and lack of a specific diagnostic characteristic—which make diagnosis difficult. Finally, details of an ELISA technique for the detection ofPseudomonas pseudomallei toxin are described. This may represent a method for rapid screening of patients allowing appropriate therapy to begin at the earliest moment.

Keywords

Pseudomonas Original Study Como Medical Problem Periodo 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

La melioïdose humaine est endémique en Asie du Sud-Est et en Australie tropicale. Toutefois, des rapports d'un nombre accru de cas arrivent d'autres parties du monde. L'accroissement des voyages de par le monde et le potentiel de l'infection de personne à personne dans les régions non-endémiques sont vraisemblablement responsables du fait que les médecins et les microbiologistes médicaux rencontrent la maladie plus souvent qu'auparavant. Tant la maladie, la melioïdose que l'organisme que la cause,Pseudomonas pseudomallei ont des caractéristiques inhabituelles, qui les rendent dignes de considération. Dans cette revue, on passe en revue la microbiologie dePseudomonas pseudomallei. On présente des études originales en présence de fimbriae et les facteurs qui influencent la pathogénicité de l'organisme sont discutés. On dècrit les propriétés des diverses endotoxines. On résume les connaissances actuelles vétérinaires et médicales relatives à la maladie. On attire l'attention sur ces faits — la latence prolongée, la multiplicité de symptômes, le manque de diagnostic spécifique — qui rendent le diagnostic difficile. Finallement, on détaille la technique ELISA pour la détection de la toxine dePseudomonas pseudomallei. Cette dernière pourrait bien être une méthode pour l'examen rapide des patients, permettant à une thérapeutique appropriée d'être mise en place au moment le plus précoce.

Resumen

La melioidosis humana es una enfermedad endémica en el Sureste Asiático y en la zona tropical de Australia. Sin embargo se ha observado un incremento del número de casos en otras partes del mundo. La posibilidad de que médicos y microbiólogos puedan encontrarse con esta enfermedad en zonas no endémicas es cada vez mayor debido al incremento en la frecuencia y el número de personas que viajan y a la posibilidad de contagio persona a persona. Tanto la enfermedad, melioidosis, como el organismo causal,Pseudomonas pseudomallei, tienen peculiaridades que los hacen dignos de estudio. En esta revisión se presentan las características microbiológicas dePsedomonas pseudomallei, junto con estudios originales sobre la presencia de ‘fimbriae’ y se discuten los factores que influyen sobre la patogenicidad del organismo. Se describen las propiedeades de varias ‘exotoxinas’. Se subrayan los conocimientos médicos y veterinarios relacionados con la enfermedad. Se llama la atención sobre las características que dificultan el diagnóstico, como: periodo de latencia prolongado, multiplicidad de síntomas y carencia de un procedimiento de diagnóstico específico. Por último se describe detalladamente una técnica ELISA para la detección de toxinas dePseudomonas pseudomallei que puede representar un método de diagnóstico rápido que permita aplicar la terapeutica apropiada sin demoras.

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Copyright information

© Oxford University Press 1987

Authors and Affiliations

  • C. J. Smith
    • 1
  • J. C. Allen
    • 1
  • M. Noor Embi
    • 2
  • O. Othman
    • 2
  • N. Razak
    • 2
  • G. Ismail
    • 3
  1. 1.Research DivisionThe North East Wales InstituteDeesideUK
  2. 2.Microbiology Department, Faculty of Life SciencesNational University of MalaysiaMalaysia
  3. 3.Faculty of Science and Natural ResourcesNational University of MalaysiaMalaysia

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