Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities. It has both acute and chronic forms. Most infection is thought to be acquired through percutaneous inoculation. It was rare in the United States prior to recent immigration from Southeast Asia. The bacillus can cause disease in sheep, goats, pigs, horses, and other animals, as well as in humans.
Pneumonia is the commonest presentation of melioidosis.
Other presentations of melioidosis include skin abscesses or ulcers, abscesses in the internal organs such as the prostate, spleen, kidney and liver, fulminant septicemia with multi-organ abscesses and unusual neurological illnesses such as brainstem encephalitis and acute paraplegia. Persons without symptoms or a known history of disease can also be found to be positive on serological testing. In addition, excessive alcohol consumption, chronic renal disease, chronic lung disease and excessive kava drinking are risk factors for melioidosis. While the majority of patients with melioidosis have one or more of these risk factors, melioidosis can also occur occasionally in children and healthy adults. Diagnosis Melioidosis is usually suspected based on the patient's history, especially travel, occupational exposure to contaminated soil, water and infected animals.