You are here

Melioidosis A032

Last amended 
29 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
60 of 2014
Balance of Probabilities SOP
61 of 2014
Changes from Previous Instruments:

SOP Bulletin 176

ICD Coding:
  • ICD-9-CM Codes: 025
  • ICD-10-AM Codes: A24.1, A24.2, A24.3, A24.4

This is a infection with a specific type of bacteria, Burkholderia pseudomallei which normally acts as a saprophyte in the soil and water of endemic areas such as Northern Australia, Southeast Asia, India, China, Thailand, Malaysia, Singapore, Papua New Guinea, New Caledonia.  The normal route of infection is via percutaneous inoculation of the skin surface or via inhalation and occasionally ingestion. The incubation period is from 1 to 24 days with an average of nine days.  The commonest manifestation is pneumonia or skin infection.

Unapparent infections by the causative bacterium can also occur and these are not covered by the SOP, which requires a clinical illness.

Is specific diagnostic evidence required to apply the SOP? – Yes.

This diagnosis is based on microbiological confirmation of the infection through microscopy, and culture, plus an appropriate pattern of clinical illness.  The relevant medical specialist for this condition would be an infectious disease physician.

Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • Infection by Burkholderia pseudomalli
  • Whitmore’s disease
Conditions excluded from SOP
  • Infection by Burkholderia mallei
  • Glanders
  • sub-clinical infection with Burkholderia pseudomallei
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. re-encode the condition, if appropriate.