Perret J L
Service de Pathologie Infectieuse et Tropicale, l'Hopital d'Instruction des Armées Laveran, Marseille, France.
Med Trop (Mars). 1997;57(2):195-201.
Melioidosis, an infectious disease that affects many mammals, was first identified in Burma by Whitmore in 1912. It is caused by Burkholderia pseudomallei, a gram negative bacillus of the Pseudomonas family, which is found in soil and water. Long present in Southeast Asia and numerous tropical areas, melioidosis has recently appeared in temperate zones including mainland France. The incidence in endemic areas is between 6% and 20% of the population and short period of exposure is sufficient to be contaminated. In man the contamination occurs mainly through skin wounds and the disease can be clinically inapparent. Diabetes, renal disease, and various forms of immunodepression are triggering factors for the onset of a variety of symptoms ranging from acute septicemia to abscesses involving almost any organ in the body. Ceftazidime alone or a combination of clavulanate and amoxicilline is the treatment of choice but the mortality rate in patients with acute forms is still 40% and relapse can occur if treatment is stopped too soon. Bacteriologic and serologic tests can fail and awareness of a history of geographic exposure is an important diagnostic criteria for this disease which has been expanded with the growth of international travel.
类鼻疽是一种影响多种哺乳动物的传染病，1912年由惠特莫尔在缅甸首次发现。它由类鼻疽伯克霍尔德菌引起，这是一种假单胞菌科的革兰氏阴性杆菌，存在于土壤和水中。类鼻疽长期存在于东南亚和许多热带地区，最近在包括法国本土在内的温带地区也有出现。在流行地区，发病率在人口的6%至20%之间，短时间接触就足以被感染。在人类中，感染主要通过皮肤伤口发生，这种疾病在临床上可能不明显。糖尿病、肾病和各种形式的免疫抑制是引发各种症状的触发因素，这些症状从急性败血症到涉及身体几乎任何器官的脓肿不等。单独使用头孢他啶或克拉维酸与阿莫西林联合使用是首选治疗方法，但急性患者的死亡率仍为40%，如果治疗过早停止可能会复发。细菌学和血清学检测可能会出现失误，了解地理暴露史是这种随着国际旅行增加而增多的疾病的重要诊断标准。
