Bacterial Diseases Abscess, Lung Abscess, Pyelonephritis, or Liver or Spleen Abscess
Lung Abscess Bronchocutaneous and other types of fistulas may appear. Patients with this chronic illness may survive for many months, and occasionally may. recover. Diagnosis. Melioidosis may resemble typhoid fever, malaria, mycotic infection, and occasionally acute staphylococcal septicemia or staphylococcal pneumonia. Chronic pulmonary disease most resembles tuberculosis. Melioidosis can be differentiated from these diseases only by bacteriologic identification of the bacillus &dm blood, sputum, urine, or pus.
Hemagglutination and complement fixation tests- may be useful when acute and convalescent serologic titers are compared. A single positive test may only indicate previous clinical and subclinical infection. The leukocyte count of the peripheral blood often is normal in melioidosis, but may rise to levels of 20,000 per cubic millimeter. Urinalysis may show pyuria and hematuria. Treatment and Prevention. There is no available antigen for active immunization against melioidosis. Prevention of the disease is possible by con-trolled sanitation and improved standards of living. Patients have been successfully treated with chloramphenicol, sulfonamides, or tetracycline, given over long periods of time.
The drug susceptibility of M. pseudomallei however, is variable. In adults, 3 grams of tetracycline a day orally for 30 days, or, alternatively, in septicemia, large doses of chloramphenicol are preferred. Surgical drainage of Lung Abscess is essential for proper management.
ANTHRAX Leighton E. Cluff
Definition. Anthrax is an infectious disease of wild and domesticated animals caused by Bacillus anthracis. Occasionally it is transmitted to man. mouse and rabbit, by its lack of hemolytic activity on blood agar, and by lysis of B. anthracis with specific bacteriophage. The serum of many animals has lytic activity' against the bacillus, but this anthracite substance seems to bear little if any, relationship to natural resistance. It is probable that B. During the course of lethal anthrax infection in laboratory animals, a bacterial toxin is produced that is responsible for the death. Intense no pitting edema, which may not be erythematous, often surrounds and may extend a considerable distance from the eschar.
The skin lesions are commonly on exposed areas of hands, arms, neck, or face; and there may be mild regional lymph node enlargement. Lymphangitis is not usually observed. Constitutional symptoms and fever are frequently absent unless the skin dis-ease is severe or the infection becomes disseminated, when high fever, prostration, and death may occur. Characteristically, this form of anthrax is severe and is associated with disseminated infection.