Clinical features of primary cutaneous meliodosis:
(1) young age (many patients <= 15 years)
(2) associated with occupational or environmental exposure
(3) tends to be a limited and chronic process
(4) lesions may be single or in a small cluster
(5) usually lack the risk factors associated with disseminated disease
(6) may be successfully treated with oral antibiotics
Clinical features of secondary cutaneous meliodosis associated with disseminated disease:
(1) multiple skin pustules
(2) presence of pneumonia and/or sepsis
(3) often have complications with a poor outcome
(4) often require aggressive antibiotic therapy with both oral and parenteral antibiotics
Primary or secondary forms of cutaneous meliodosis will have positive cultures for B. pseudomallei.
Complications of cutaneous meliodosis:
(1) necrotizing fasciitis
(2) septicemia
(3) visceral abscesses
Recommended workup for a patient with cutaneous meliodosis:
(1) blood cultures
(2) chest X-rays
(3) abdominal CT
