Melioidosis is an infectious disease caused by the bacteria Burkholderia pseudomallei found in contaminated soil and water. It can present as acute, subacute, or chronic pulmonary or bloodstream infection, or local or disseminated infection. Symptoms vary depending on infection type but include fever, cough, chest pain, skin ulcers, and joint pain. Diagnosis involves culture of bacteria from blood, urine, or throat samples. Treatment requires long-term intravenous antibiotics initially followed by oral antibiotics for several months. Nursing management includes monitoring for symptoms like fever and seizures, educating on medication administration and avoiding contaminated environments, and assessing for risk of infection.

1. Melioidosis

2. Melioidosis
Melioidosis, also called Whitmore's Disease, is
an infectious disease

3. Pathogenesis
• The disease can manifest as Acute, Sub acute, and Chronic
disease
• Incubation may be as short as 3 days
• Latent infections can occurs after months to years
• The infection starts with non specific lesion at the inoculum,
where there can be break in the skin.
• Lead to septicemia
• Most common form is pulmonary infection
• Can lead to suppurative infection and bacteremia

4. Cause
caused by a bacterium called Burkholderia
pseudomallei (previously known as Pseudomonas
pseudomallei). The bacteria are found in
contaminated water and soil and spread to
humans and animals through direct contact with
the contaminated source.

5. Sign and symptom
• Pulmonary infection
• Bloodstream infection
• Local infection
• Disseminated infection

6. Pulmonary infection
• cough with normal sputum
• chest pain during breathing
• high fever
• headache and general muscle soreness

7. Bloodstream infection
• Septic shock usually occurs quickly
• breathing problems, including shortness of breath
• upper abdominal pain
• diarrhea
• joint pain and muscle tenderness
• sores with pus on the skin or internally in the liver,
spleen, muscle, or prostate

8. Local infection
• pain or swelling in a contained (localized) area, such
as the parotid glands, which are most commonly
associated with mumps and are located below and in
front of the ear
• ulcerations or abscesses on, or just below, the skin
these may start as firm, gray or white nodules that
become soft and inflamed, and then look like wounds
caused by flesh-eating bacteria

9. Disseminated infection
• stomach or chest pain
• muscle or joint pain
• headache
• seizures

10. Diagnosis
• blood, urine and throat swab culture
• Ultrasound for abdomen
• Confirm laboratory that “selective media for B.
pseudomallei” and “latex agglutination” are used

11. Treatment
When a melioidosis infection is diagnosed, the
disease can be treated with the use of appropriate
medication.
• Intravenous antimicrobial therapy for 10-14 days
Ex. Ceftazidime
• Oral antimicrobial therapy for 3-6 months
Ex. Trimethoprim-sulfamethoxazole

12. Prevention
• Avoid direct exposure to wet season soil, dust
clouds, heavy rain and surface water
• Wear protective gears
• Drink boiled or bottled water only
• Avoid travel to endemic area for high-risk patients
• Health care workers: standard contact precaution

13. Nursing diagnosis
• Risk for Infection related to insufficient
knowledge to avoid exposure to pathogens.
• Hyperthermia related to exposure to
infection.
• Deficient Knowledge related to lack of
exposure to information.

14. Nursing management
• Review pathology of disease and potential
spread of infection
• Monitor VS especially temperature, every 2-4
hours and prn.
• Monitor patient for seizures.
• Explain medication dosage, frequency of
administration, expected action, and the reason
for long treatment period. Review potential
interactions with other drugs and substances.

15. Nursing management
• Instruct patient/family on medications, side
effects, and symptoms to report to nurse.
• Instruct patient/family to avoid direct
exposure to wet season soil, dust, clouds,
heavy rain and surface water.

16. Questions
• 1. What is the nursing management
for melioidosis disease?
• 2. What is cause of melioidosis
disease?

17. Reference
Matt Vera.(2013).Communicable and Infectious Diseases.Retrieved September,7,2018 from
https://nurseslabs.com/nursing-care-plans/#communicable-and-infectious-diseases
Marilynn E.Doenges,Mary Frances Moorhouse and Alice C. Murr.(2012).Nursing Care Plans:
Guidelines for Individualizing Client Care Across the life span.Retrieved September,7,2018
from https://eclass.teicrete.gr/modules/document/file.php/YN130/Nursing%20Care
%20Plans%2C%20Edition%209%20-%20Murr%2C%20Alice%2C%20Doenges%2
C%20Marilynn%2C%20Moorehouse%2C%20Mary.pdf
Limmathorotsakul D.(2012).Melioidosis:Burkholderia pseudomallei.Retrieved
September,8,2018 fromhttp://www.tm.mahidol.ac.th/nursing/sites/
default/files/KM/Melioidosis.pdf

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