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TM: Melioidosis (i) (Intro (Nodule which undergoes central necrosis, can…
TM: Melioidosis (i)
Intro
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found in soil, mud + surface water in endemic regions
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endemic so SE Asia (esp NE Thailand, where 20% of community-acquired septicaemia occurs as a result of melioidosis, 3rd most common cause of death behind TB+HIV), N Australia (Darwin, Nightcliff - called Gardener's disease)
few cases in S Pacific, Africa, India, N S America (Mexico), Middle East
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OI
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DM, chronic renal disease, chronic lung disease, liver disease, steroids, haematological malignancies, pregnancy
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Nodule which undergoes central necrosis, can be anywhere
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lungs most commonly
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predilection for upper lobes, but spares apices (unlike TB)
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varying spectrum of disease: from asymptomatic to septicaemia requiring inotropic + ventilator support
dDx
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pneumonia (S aureus, S pneumo, K pneumo)
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