Acute Schematic depiction of the signs of<unk>  Chest X-ray showing opacity of the left middle and lower zones of the lung. CT and MRI scans showing lesion of the right frontal lobe of the brain. Septic arthritis of the left hip with joint destruction Exposure to Burkholderia pseudomallei may commonly cause antibodies to be produced against it without any symptoms. Of the patients who do develop clinical infection, 85% experience acute symptoms from a recent acquisition of the bacterium. The mean incubation period of acute<unk>  is 9 days (range 1–21 days). Nevertheless, symptoms of<unk>  can appear in 24 hours for those who are infected during a near drowning in contaminated water. Those affected present with symptoms of sepsis (predominantly fever) with or without pneumonia, or localised abscess or other focus of infection. The presence of nonspecific signs and symptoms has caused<unk>  to be nicknamed "the great mimicker". People with diabetes mellitus or regular exposure to the bacteria are at increased risk of developing<unk> . The disease should be considered in those staying in endemic areas who develop fever, pneumonia, or abscesses in their liver, spleen, prostate, or parotid glands. The clinical manifestation of the disease can range from simple skin changes to severe organ problems. Skin changes can be nonspecific abscesses or ulcerations. In northern Australia, 60% of the infected children presented with only skin lesions, while 20% presented with pneumonia. The commonest organs affected are liver, spleen, lungs, prostate, and kidneys. Among the most common clinical signs are presence of bacteria in blood (in 40 to 60% of cases), pneumonia (50%), and septic shock (20%). People with only pneumonia may have a prominent cough with sputum and shortness of breath. However, those with septic shock together with pneumonia may have minimal coughing. Results of a chest X-ray can range from diffuse nodular infiltrates in those with septic shock to progressive solidification of the lungs in the upper lobes for those with pneumonia only. Excess fluid in the pleural cavity and gathering of pus within a cavity are more common for<unk>  affecting lower lobes of the lungs. In 10% of cases, people develop secondary pneumonia caused by other bacteria after the primary infection. Depending on the course of infection, other severe manifestations develop. About 1 to 5% of those infected develop inflammation of the brain and brain covering or collection of pus in the brain; 14 to 28% develop bacterial inflammation of the kidneys, kidney abscess or prostatic abscesses; 0 to 30% develop neck or salivary gland abscesses; 10 to 33% develop liver, spleen, or paraintestinal abscesses; 4 to 14% develop septic arthritis and osteomyelitis. Rare manifestations include lymph node disease resembling tuberculosis, mediastinal masses, collection of fluid in the heart covering, abnormal dilatation of blood vessels due to infection, and inflammation of the pancreas. In Australia, up to 20% of infected males develop prostatic abscess characterized by pain during urination, difficulty in passing urine, and urinary retention requiring catheterisation. Rectal examination shows inflammation of the prostate. In Thailand, 30% of the infected children develop parotid abscesses. Encephalomyelitis can occur in healthy people without risk factors. Those with<unk>  encephomyelitis tend to have normal computed tomography scans, but increased T2 signal by magnetic resonance imaging, extending to the brain stem and spinal cord. Clinical signs include: unilateral upper motor neuron limb weakness, cerebellar signs, and cranial nerve palsies (VI, VII nerve palsies and bulbar palsy). Some cases presented with flaccid paralysis alone. In northern Australia, all<unk>  with encephalomyelitis cases had elevated white cells in the cerebrospinal fluid (CSF), mostly mononuclear cells with elevated CSF protein. Chronic Chronic<unk>  is usually defined by symptoms lasting longer than two months, and occurs in about 10% of patients. Clinical presentations include fever, weight loss, and productive cough with or without bloody sputum, which may mimic tuberculosis. Additionally, long-standing abscesses at multiple body sites may also present. Tuberculosis should be considered if lymph nodes are enlarged at the root of the lung. Chronic<unk>  may present with cavitating pneumonia resembling chronic pulmonary tuberculosis. Pneumonia caused by<unk>  rarely causes scarring and calcification of the lungs, unlike tuberculosis. Latent In latent infection, immunocompetent people can clear the infection without showing any symptoms, but less than 5% of all<unk>  cases have activation after a period of latency. Patients with latent<unk>  may be symptom-free for decades. Initially, the longest period between presumed exposure and clinical presentation was thought to be 62 years in a Second World War prisoner of war in Burma-Thailand-Malaysia. Subsequent genotyping of the bacterial isolate from said veteran, though, showed that the isolate may not have come from Southeast Asia, but from South America. This reinstates another report that put the longest latency period for<unk>  as 29 years. The potential for prolonged incubation was recognized in US servicemen involved in the Vietnam War, and was referred to as the "Vietnam time-bomb". In Australia, the longest recorded latency period is 24 years. Various comorbidities such as diabetes, renal failure, and alcoholism can predispose to reactivation of<unk> .
Melioidosis
Sarcoidosis
Tuberculosis
Gamasoidosis
Amyloidosis
Miliary tuberculosis
Chronic pulmonary aspergillosis
Extrapulmonary tuberculosis