Very rarely, laboratory workers have acquired infection. The clinical manifestations of melioidosis are markedly varied. Recrudescent infection may appear years after departure from an endemic area and may take several clinical forms. Clinical syndromes occasionally observed by practitioners in the United States include acute septicemia, chronic suppurative infections, and recrudescent infections. Acute septicemia may develop after a cutaneous infection or as a complication of an acute pneumonia caused by melioidosis.
Manifestations are indistinguishable from other types of gram-negative bacillary septicemia.
In a few patients, diarrhea is sufficiently prominent to suggest a primary gastroenteritis. The peripheral leukocyte count may be either normal or slightly elevated. Chronic cavitary lesions in the upper lobes of the lungs may develop months or years after an initial acute or inapparent infection, suggesting the diagnosis of pulmonary tuberculosis or chronic lung abscess. Chronic abscesses secondary to a primary septicemic illness can also develop. Manifestations include liver abscesses, osteomyelitis, subcutaneous abscesses, or a suppurative lymphadenitis in which sinus tracts are formed.