Last updated: December 6, 2019

Summarytoggle arrow icon

Melioidosis, also known as Whitmore disease, is an infectious disease caused by the bacterium Burkholderia pseudomallei. It is predominantly seen in tropical climates in Southeast Asia and Northern Australia, where it is transmitted via contact with contaminated water or soil. The clinical course of Melioidosis can vary greatly, ranging from asymptomatic disease to acute or chronic infection. In some cases, there is a latency period after initial infection, followed by reactivation. Symptomatic disease manifests with localized symptoms, pulmonary symptoms, or disseminated systemic symptoms. Antimicrobial therapy is the mainstay of treatment; in severe cases, adjunct therapy is also required. There are no vaccinations available against B. pseudomallei; prevention involves avoiding potentially contaminated sources, wearing protective gear in environments where there is a risk of contracting the pathogen, and observing general contact measures when interacting with infected patients (e.g., gloves, gowns).

Epidemiologytoggle arrow icon

  • Distribution: occurs in tropical climates, mainly in Southeast Asia (e.g., Thailand, Malaysia) and Northern Australia
  • Incidence: ∼ 150,000 case/year worldwide, with most cases occurring in wet seasons


Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

  • Pathogen: Burkholderia pseudomallei
    • Facultative intracellular gram-negative bacterium
  • Transmission
    • Percutaneous inoculation: contact with contaminated soil or water (most common)
    • Inhalation, aspiration, or ingestion of contaminated dust or water
    • Person-to-person transmission is rare


Clinical featurestoggle arrow icon


Diagnosticstoggle arrow icon


Differential diagnosestoggle arrow icon


The differential diagnoses listed here are not exhaustive.

Treatmenttoggle arrow icon


Preventiontoggle arrow icon

  • In endemic areas, contact with soil and standing water should be avoided (e.g., agricultural workers should wear boots).
  • Health care and laboratory workers should wear masks, gloves, and gowns to prevent infection.
  • No vaccination available


Referencestoggle arrow icon

  1. Currie B, Anstey NM. Epidemiology, Clinical Manifestations, and Diagnosis of Melioidosis. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. Last updated: September 6, 2018. Accessed: December 2, 2018.
  2. Melioidosis - Transmission. Updated: January 26, 2012. Accessed: December 2, 2018.
  3. Signs and Symptoms. Updated: October 22, 2012. Accessed: December 2, 2018.
  4. Currie B, Anstey NM. Treatment and Prognosis of Melioidosis. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. Last updated: November 2, 2018. Accessed: December 2, 2018.
  5. Melioidosis - Treatment. Updated: May 23, 2018. Accessed: December 2, 2018.
  6. Melioidosis - Prevention. Updated: January 26, 2012. Accessed: December 2, 2018.

Icon of a lock3 free articles remaining

You have 3 free member-only articles left this month. Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer