The Academic Article on “Melioidosis in Children”
Article Sidebar
Main Article Content
Abstract
Melioidosis is an infectious disease caused by the Gram-negative bacteria Burkholderia pseudomallei, which is commonly found in soil and water in tropical countries, particularly in Southeast Asia and northern Australia. In Thailand, the disease is prevalent in the Northeast, especially during the rainy season. Transmission occurs through percutaneous inoculation, ingestion, or inhalation. Clinical manifestations are diverse. Adults with melioidosis often have underlying comorbidities, such as diabetes or kidney disease, and most commonly present with lung infections. In contrast, children with melioidosis usually have no underlying diseases, which differs from adults. Common presentations in children are localized infections, such as skin infections or suppurative parotitis, which is frequently reported in children in Thailand. The gold standard for diagnosis is bacterial culture from clinical specimens. Treatment is divided into two phases: 1) an initial intensive therapy phase with intravenous antibiotics, for which ceftazidime is the primary drug, and 2) an eradication therapy phase with oral antibiotics to prevent recurrence, for which co-trimoxazole is the primary drug. Currently, there is no vaccine available; therefore, prevention focuses on avoiding direct contact with soil or water for high-risk individuals.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Currie BJ, Anstey NM. Melioidosis: Epidemiology, clinical manifestations, and diagnosis. UpToDate [Internet]. [cited 2025 Sep 1]. Available from:URL: https://www.uptodate.com/contents/melioidosis-epidemiology-clinical-manifestations-and-diagnosis.
Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 2005;18(2):383-416. doi: 10.1128/CMR.18.2.383-416.2005.
Vuddhakul V, Tharavichitkul P, Na-Ngam N, Jitsurong S, Kunthawa B, Noimay P, et al. Epidemiology of Burkholderia pseudomallei in Thailand. Am J Trop Med Hyg 1999;60(3):458-61. doi: 10.4269/ajtmh.1999.60.458.
Leelarasamee A, Bovornkitti S. Melioidosis: review and update. Rev Infect Dis 1989;11(3):413-25. doi: 10.1093/clinids/11.3.413.
Currie BJ, Mayo M, Ward LM, Kaestli M, Meumann EM, Webb JR, et al. The Darwin Prospective Melioidosis Study: a 30-year prospective, observational investigation. Lancet Infect Dis 2021;21(12):1737-46. doi: 10.1016/S1473-3099(21)00022-0.
Lumbiganon P, Viengnondha S. Clinical manifestations of melioidosis in children. Pediatr Infect Dis J 1995;14(2):136-40. doi: 10.1097/00006454-199502000-00010.
McLeod C, Morris PS, Bauert PA, Kilburn CJ, Ward LM, Baird RW, et al. Clinical presentation and medical management of melioidosis in children: a 24-year prospective study in the Northern Territory of Australia and review of the literature. Clin Infect Dis 2015;60(1):21-6. doi: 10.1093/cid/ciu733.
Pagnarith Y, Kumar V, Thaipadungpanit J, Wuthiekanun V, Amornchai P, Sin L, et al. Emergence of pediatric melioidosis in Siem Reap, Cambodia. Am J Trop Med Hyg 2010;82(6):1106-12. doi: 10.4269/ajtmh.2010.10-0030.
Currie BJ, Fisher DA, Anstey NM, Jacups SP. Melioidosis: acute and chronic disease, relapse and re-activation. Trans R Soc Trop Med Hyg 2000;94(3):301-4. doi: 10.1016/s0035-9203(00)90333-x.
Chantratita N, Phunpang R, Yarasai A, Dulsuk A, Yimthin T, Onofrey LA, et al. Characteristics and One Year Outcomes of Melioidosis Patients in Northeastern Thailand: A Prospective, Multicenter Cohort Study. Lancet Reg Health Southeast Asia 2023;9:100118. doi: 10.1016/j.lansea.2022.100118.
Wiersinga WJ, Currie BJ, Peacock SJ. Melioidosis. N Engl J Med 2012;367(11):1035-44. doi: 10.1056/NEJMra1204699.
Mohan A, Podin Y, Tai N, Chieng CH, Rigas V, Machunter B, et al. Pediatric melioidosis in Sarawak, Malaysia: Epidemiological, clinical and microbiological characteristics. PLoS Negl Trop Dis 2017;11(6):e0005650. doi: 10.1371/journal.pntd.0005650.
Dance DA, Davis TM, Wattanagoon Y, Chaowagul W, Saiphan P, Looareesuwan S, et al. Acute suppurative parotitis caused by Pseudomonas pseudomallei in children. J Infect Dis 1989;159(4):654-60. doi: 10.1093/infdis/159.4.654.
แกมกาญจน์ ศิลปโภชากุล. โรคเมลิออยโดสิสในเด็กภาคใต้. สงขลานครินทร์เวชสาร 2547;22(ฉบับพิเศษ 2):363-9.
Turner P, Kloprogge S, Miliya T, Soeng S, Tan P, Sar P, et al. A retrospective analysis of melioidosis in Cambodian children, 2009-2013. BMC Infect Dis 2016;16(1):688. doi: 10.1186/s12879-016-2034-9.
Kandasamy Y, Norton R. Paediatric melioidosis in North Queensland, Australia. J Paediatr Child Health 2008;44(12):706-8. doi: 10.1111/j.1440-1754.2008.01410.x.
Thatrimontrichai A, Maneenil G. Neonatal melioidosis: systematic review of the literature. Pediatr Infect Dis J 2012;31(11):1195-7. doi: 10.1097/INF.0b013e318265ac62.
Laopaiboon V, Chamadol N, Buttham H, Sukeepaisarnjareon W. CT findings of liver and splenic abscesses in melioidosis: comparison with those in non-melioidosis. J Med Assoc Thai 2009;92(11):1476-84. PMID: 19938740.
Kingsley PV, Arunkumar G, Tipre M, Leader M, Sathiakumar N. Pitfalls and optimal approaches to diagnose melioidosis. Asian Pac J Trop Med 2016;9(6):515-24. doi: 10.1016/j.apjtm.2016.04.003.
Chaichana P, Jenjaroen K, Amornchai P, Chumseng S, Langla S, Rongkard P, et al. Antibodies in Melioidosis: The Role of the Indirect Hemagglutination Assay in Evaluating Patients and Exposed Populations. Am J Trop Med Hyg 2018;99(6):1378-85. doi: 10.4269/ajtmh.17-0998.
Hoffmaster AR, AuCoin D, Baccam P, Baggett HC, Baird R, Bhengsri S, et al. Melioidosis diagnostic workshop, 2013. Emerg Infect Dis 2015;21(2):e141045. doi: 10.3201/eid2102.141045.
Chierakul W, Anunnatsiri S, Chaowagul W, Peacock SJ, Chetchotisakd P, Day NP. Addition of trimethoprim-sulfamethoxazole to ceftazidime during parenteral treatment of melioidosis is not associated with a long-term outcome benefit. Clin Infect Dis 2007;45(4):521-3. doi: 10.1086/520010.
Chierakul W, Anunnatsiri S, Short JM, Maharjan B, Mootsikapun P, Simpson AJ, et al. Two randomized controlled trials of ceftazidime alone versus ceftazidime in combination with trimethoprim-sulfamethoxazole for the treatment of severe melioidosis. Clin Infect Dis 2005;41(8):1105-13. doi: 10.1086/444456.
Simpson AJ, Suputtamongkol Y, Smith MD, Angus BJ, Rajanuwong A, Wuthiekanun V, et al. Comparison of imipenem and ceftazidime as therapy for severe melioidosis. Clin Infect Dis 1999;29(2):381-7. doi: 10.1086/520219.
Cheng AC, Fisher DA, Anstey NM, Stephens DP, Jacups SP, Currie BJ. Outcomes of patients with melioidosis treated with meropenem. Antimicrob Agents Chemother 2004;48(5):1763-5. doi: 10.1128/AAC.48.5.1763-1765.2004.
Chetchotisakd P, Porramatikul S, Mootsikapun P, Anunnatsiri S, Thinkhamrop B. Randomized, double-blind, controlled study of cefoperazone-sulbactam plus cotrimoxazole versus ceftazidime plus cotrimoxazole for the treatment of severe melioidosis. Clin Infect Dis 2001;33(1):29-34. doi: 10.1086/320878.
Cheng AC, Chierakul W, Chaowagul W, Chetchotisakd P, Limmathurotsakul D, Dance DA, et al. Consensus guidelines for dosing of amoxicillin-clavulanate in melioidosis. Am J Trop Med Hyg 2008;78(2):208-9. PMID: 18256414.
Suputtamongkol Y, Rajchanuwong A, Chaowagul W, Dance DA, Smith MD, Wuthiekanun V, et al. Ceftazidime vs. amoxicillin/clavulanate in the treatment of severe melioidosis. Clin Infect Dis 1994;19(5):846-53. doi: 10.1093/clinids/19.5.846.
Anothaisintawee T, Harncharoenkul K, Poramathikul K, Phontham K, Boonyarangka P, Kuntawunginn W, et al. Efficacy of drug treatment for severe melioidosis and eradication treatment of melioidosis: A systematic review and network meta-analysis. PLoS Negl Trop Dis 2023;17(6):e0011382. doi: 10.1371/journal.pntd.0011382.
Currie B. Melioidosis: the 2014 revised RDH guideline. NT Disease Control Bulletin 2014;21(2):4-8.
