چکیده (انگلیسی):

Melioidosis is a severe and fatal infectious disease in the tropics and subtropics. It presents
as a febrile illness with protean manifestation ranging from chronic localized
infection to acute fulminant septicemia with dissemination of infection to multiple organs
characterized by abscesses. Pneumonia is the most common clinical presentation.
Because of the wide range of clinical presentations, physicians may often misdiagnose
and mistreat the disease for tuberculosis, pneumonia or other pyogenic infections. The
purpose of this paper is to present common pitfalls in diagnosis and provide optimal
approaches to enable early diagnosis and prompt treatment of melioidosis. Melioidosis
may occur beyond the boundaries of endemic areas. There is no pathognomonic feature
specific to a diagnosis of melioidosis. In endemic areas, physicians need to expand the
diagnostic work-up to include melioidosis when confronted with clinical scenarios of
pyrexia of unknown origin, progressive pneumonia or sepsis. Radiological imaging is an
integral part of the diagnostic workup. Knowledge of the modes of transmission and risk
factors will add support in clinically suspected cases to initiate therapy. In situations of
clinically highly probable or possible cases where laboratory bacteriological confirmation
is not possible, applying evidence-based criteria and empirical treatment with antimicrobials
is recommended. It is of prime importance that patients undergo the full course of
antimicrobial therapy to avoid relapse and recurrence. Early diagnosis and appropriate
management is crucial in reducing serious complications leading to high mortality, and in
preventing recurrences of the disease. Thus, there is a crucial need for promoting
awareness among physicians at all levels and for improved diagnostic microbiology
services. Further, the need for making the disease notifiable and/or initiating melioidosis
registries in endemic countries appears to be compelling.