II. Cause

  1. Burkholderia mallei (Malleomyces mallei)
    1. Formerly categorized as Pseudomonas

III. Pathophysiology

  1. Gram Negative bacillus
  2. Previously only domesticated animal infection
    1. Horses, Mules, and Donkeys
    2. Historically contracted by animal handlers (rare)
    3. No naturally acquired human cases in last 60 years
  3. Aerosolized risk as a biological warfare agent
    1. Infection rate in those exposed to aerosol: 46%
  4. Incubation: 10-14 days after inhalation

IV. Symptoms (Septicemic form)

V. Signs

  1. Acute (Septicemic form)
    1. Fever
    2. Cervical adenopathy
    3. Splenomegaly
    4. Rash
      1. Generalized papular or pustular eruptions
  2. Chronic form
    1. Rash
      1. Cutaneous and intramuscular abscess
    2. Nasal Discharge and ulceration (50%)

VI. Labs

  1. Exudate Methylene blue stain
    1. Scant small bacilli
  2. Sputum Culture on meat nutrient mediums
  3. Complete Blood Count
    1. Mild Leukocytosis with Left Shift

VII. Radiology: Chest XRay

  1. Miliary Nodules (0.5 - 1.0 cm)
    1. Small, multiple Lung Abscesses
  2. Bronchopneumonia
  3. Lobar Pneumonia
  4. Necrotizing nodular lesions

VIII. Course

  1. Uniformly fatal if untreated

X. Prevention

XI. References

  1. (1998) Medical Management of Biological Casualties
    1. U.S. Army Medical Research Institute of ID

Images: Related links to external sites (from Bing)

Related Studies