Kanai K, Dejsirilert S
National Institute of Health, Soi Bamrasnaradura Hospital, Amphur Muang, Nonthaburi, Thailand.
Jpn J Med Sci Biol. 1988 Aug;41(4):123-57. doi: 10.7883/yoken1952.41.123.
Melioidosis is a long-known disease since 1912, but only quite recently we have obtained the knowledges about its actual clinical and epidemiological features. The disease is so unique in having a wide spectrum of disease course and clinical manifestation. The causative agent, P. pseudomallei, is free-living bacterium in the natural environments (soil and surface water) of tropical and subtropical areas. Just like legionnaires' disease, melioidosis is a good example of infectious disease in which pneumonia is produced by inhalation of contaminated soil dusts or water droplets. The infection becomes dormant for years, but with a chance of recrudescence under a variety of insults to the host resistance. The disease, may it be acute or chronic, will be symptomatically confused with malaria, typhoid fever, leptospirosis, septicemia caused by other gram-negative bacteria, tuberculosis and mycotic infections. Isolation of the causative agent from clinical specimens is the only reliable method for diagnosis. Because of the increasing clinical awareness and the development of diagnostic methods, the reported cases of melioidosis have numbered almost one thousand in Thailand during the past 20 years. This country has now the most ample clinical experiences on melioidosis. We have reviewed the history of melioidosis research from bacteriological, immunological, clinical and epidemiological viewpoints, especially including the recent reports in Thailand.
类鼻疽自1912年起就是一种广为人知的疾病，但直到最近我们才了解到其实际的临床和流行病学特征。该疾病的独特之处在于其病程和临床表现具有广泛的多样性。病原体伪鼻疽伯克霍尔德菌是热带和亚热带地区自然环境（土壤和地表水）中的一种自由生活细菌。就像军团病一样，类鼻疽是一种因吸入受污染的土壤灰尘或水滴而引发肺炎的传染病的典型例子。感染可能潜伏数年，但在宿主抵抗力受到各种损害时可能会复发。无论是急性还是慢性疾病，其症状都可能与疟疾、伤寒、钩端螺旋体病、其他革兰氏阴性菌引起的败血症、结核病和霉菌感染相混淆。从临床标本中分离出病原体是唯一可靠的诊断方法。由于临床意识的提高和诊断方法的发展，在过去20年中，泰国报告的类鼻疽病例已近1000例。该国目前拥有关于类鼻疽最丰富的临床经验。我们从细菌学、免疫学、临床和流行病学角度回顾了类鼻疽的研究历史，尤其包括泰国最近的报告。
