Distribution: tropical regions from around the world. It is endemic in Southeast Asia (Burma, Thailand, Cambodia, Vietnam, Laos, southern China, and northern Australia)
Risk factors for meliodosis:
(1) diabetes mellitus
(2) thalassemia
(3) renal disease (renal insufficiency or failure, calculi, other)
(4) excessive alcohol consumption
(5) Kava use
(6) chronic lung disease, including cystic fibrosis
(7) exposure to soil and environmental water (farmer, Australian Aborigine)
(8) age >= 45 years of age
(9) male gender (perhaps due to higher soil and water exposure, alcohol abuse and/or chronic lung disease)
(10) post-splenectomy
(11) defect in host defense, especially neutrophil function (neutropenia, aplastic anemia, chronic granulomatous disease, steroid use, immunosuppression, organ transplantation)
(12) malignancy
Other associations:
(1) hemosiderosis
(2) glucose-6-phosphatase deficiency
(3) mycobacterial disease
(4) Dengue hemorrhagic fever
