infectious diseases
Melioidosis
Diagnosis of Melioidosis
Staining and culture B. pseudomalleican be identified in exudates bymethylene blueor Gram stain and by culture. Blood cultures often remain negative except when there is marked bacteremia (eg, in septicemia). Serologic assays are often unreliable in endemic areas because positive results may be due to previous infection. Chest x-rays usually show irregular, nodular (4 to 10 mm) densities but may also show lobar infiltrates, bilateral bronchopneumonia, or cavitary lesions. Ultrasonography or CT of the abdomen and pelvis should probably be done to detect abscesses, which may be present regardless of the clinical presentation. The liver and spleen may be palpable. Liver tests, aspartate aminotransferase (AST), and bilirubin are often abnormal. Renal insufficiency and coagulopathy may be present in severe cases. The white blood cell count is normal or slightly increased. 