Approach

Melioidosis follows exposure to, and infection with, the soil and water bacterium Burkholderia pseudomallei.[40][55] Hot spots for infection are northeast Thailand and northern Australia, but melioidosis is endemic in most countries of Southeast Asia and South Asia and is increasingly being documented from countries in Africa and Central and South America.[24][25][56][57][58] Local resources are available in many endemic areas, such as:

Infection can occur in travellers from those locations, and has also been reported in non-endemic countries including France, the US, Saudi Arabia, and China.[26][27][28][29][30] The vast majority of cases of melioidosis are from recent infection, but latency and subsequent activation years after infection is well recognised although rare.[7][37][39]

Glanders is a disease of horses and other equines caused by a closely related bacterium, Burkholderia mallei, that can sometimes be transmitted to humans, although human glanders is extremely rare nowadays.[3][4][38]

Both conditions have a similar clinical presentation and have been considered together throughout this topic.

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