Melioidosis: An Emerging Disease

Abstract

Melioidosis is an emerging infectious disease caused by Burkholderia pseudomallei, a Gram-negative, facultative intracellular bacterium that persists in soil and water, particularly in tropical and subtropical environments. Infection occurs mainly through inoculation, inhalation, or ingestion following environmental exposure. The disease affects humans and a broad range of animal species and may present as localised infection, pneumonia, abscess formation, chronic disease, or severe septicaemia. Its clinical and pathological manifestations can resemble tuberculosis, glanders, and other septic conditions, contributing to diagnostic difficulty and under-recognition. This review provides an integrated overview of the history and epidemiology, aetiology, host range, transmission, pathogenesis, clinical manifestations, lesions, diagnosis, treatment, prevention, and biothreat relevance of melioidosis. Particular attention is given to its expanding recognition in India and to environmental and climatic factors associated with exposure. The intracellular survival, immune evasion, latency, antimicrobial resistance, and environmental persistence of B. pseudomallei complicate disease management and control. Culture remains central to laboratory confirmation, while molecular and antigen-based methods can support diagnosis and epidemiological investigation. Effective control requires timely diagnosis, appropriate treatment, environmental awareness, preventive hygiene, strengthened surveillance, and coordinated participation of medical, veterinary, public health, and environmental sectors. These features establish melioidosis as an important One Health concern requiring sustained awareness and integrated surveillance.