Meliodosis (Burkholderiapseudomallei) is found in tropical and nontropical regions of the world. It can be spread by several mechanisms, including through aerosols.
Presentation:
(1) pneumonia, sepsis and/or meningoencephalitis caused by a Gram-negative bacteria
(2) isolation of Burkholderiapseudomallei (which may be initially misidentified)
(3) exclusion of travel to a region endemic for meliodosis
Finding the source requires a careful epidemiologic investigation. In a recent US outbreak the source was an aromatherapy room spray imported from a meliodosis-endemic region (India).
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