Criteria for inhalational meliodosis - all of the following:
(1) the onset of respiratory symptoms in the 4 weeks prior to presentation - cough, pleuric chest pain, shortness of breath, etc
(2) evidence of sepsis (see below)
(3) the presence of an alveolar infiltrate on chest X-rays within 48 hours of admission AND not present on old chest X-rays
(4) absence of percutaneous inoculation injury in an appropriate setting (needle stick injury in the laboratory, contaminated soil or mud, surface water in endemic area, etc)
(5) presence of an inhalational event (aspiration of surface water, known exposure to aerosolized meliodosis, recent severe weather event)
(6) isolation of Burkholderai pseudomallei in culture from any site
Criteria for sepsis - 2 or more of the following:
(1) body temperature < 36°C or > 38°C
(2) heart rate > 90 beats per minute
(3) respiratory rate > 20 breaths per minute
(4) white blood cell count < 4,000 or > 12,000 per µL
(5) > 10% band forms
