Prognosis
Mortality is closely linked to timeliness of diagnosis, access to, and early commencement of, intravenous antibiotic treatment, and access to a state-of-the-art intensive care unit (ICU) for management of severe pneumonia and septic shock.[8] In addition, underlying host risk factors are critical, with death very uncommon in healthy patients provided diagnosis and therapy are optimum.
Mortality range:[8]
<10% if access to timely diagnosis, appropriate antibiotics, and state-of-the-art ICU care
>40% where these are not routinely available; in these circumstances mortality is >90% for melioidosis septic shock.
Natural history of disease
While melioidosis requires prolonged therapy, if the patient survives then recovery can be complete, but underlying risk factors may influence this.
Recrudescence of disease during treatment can occur if the duration of intensive intravenous therapy is inadequate or the patient is not adherent to the full treatment regimen.
Relapse of melioidosis is <5% of cases provided adequate and full therapy is completed, but can be as high as 10% to 15% if not.[85]
Re-infection with a new strain of Burkholderia pseudomallei can occur as natural immunity frequently does not follow infection.
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