TL;DR
The disease and human cases in Mexico are described and it is argued why melioidosis represents an emerging public health problem in the region.
Melioidosis, caused by the gram-negative bacillus Burkholderia pseudomallei - a Tier 1 Select Biological agent - remains a significant cause of severe community-acquired infection in tropical regions, but with recent expanding recognition in temperate climates, including the United States. Pulmonary involvement is the most frequent clinical manifestation, ranging from subclinical nodules to fulminant necrotizing pneumonia and acute respiratory distress syndrome. Despite its clinical severity, melioidosis remains underdiagnosed due to its radiologic mimicry of tuberculosis, broad clinical manifestations, and limited laboratory capacity in many endemic areas. Special Operations Forces (SOF) participating in field exercises or operations in B. pseudomallei endemic countries are at significantly increased risk of infection. Accordingly, SOF medical providers should maintain a high index of suspicion for melioidosis and be familiar with its clinical recognition, diagnosis, and management.
Melioidosis, caused by Burkholderia pseudomallei, is an emerging disease in the United States and was declared endemic to the Gulf Coast region in 2022. Melioidosis has been sporadically reported in the American continents, the Caribbean, and more recently in Africa. We conducted lethal dose analyses in BALB/c and C57BL/6 mice exposed to small particle aerosols of B. pseudomallei strains from the Western Hemisphere and Africa. Those isolates exhibit a variety of virulence patterns, including rapidly-lethal disease and delayed onset of fatal disease. We found that the isolates we tested grew similarly in culture but displayed major differences in biofilm formation. Our data contribute to the growing knowledge of geographically distinct B. pseudomallei isolates and aid in ensuring that medical countermeasures in development are effective against a diverse collection of bacterial strains.
The presence of severe melioidosis in the Peruvian Amazon highlights the presence of Burkholderia pseudomallei and underscores the need to consider this pathogen in patients presenting with severe sepsis in tropical regions with high environmental exposure and metabolic risk factors.
Background: The movement of endemic diseases from tropical and disadvantaged areas is gradually spreading to developed countries as well. Amoebiasis, in particular, represents a significant threat to public health, amplified by globalization and increasing contact between humans and animals or vectors. In this way, atypical diseases may emerge in our country, also through an unusual mode of transmission—likely sexual, as “sexually transmitted enteric (STE) diseases”. Objective: We report and discuss the clinic approach to a rare case of dual human infestations by ecto- and endo-parasites with multiple liver abscesses presentation in a young truck driver residing in Northern Italy. Methods: The patient underwent a comprehensive screening with laboratory and microbiological tests, and CT images. Results: In July, the patient was admitted to our hepatology unit following the ultrasound identification of two hypoechoic lesions in the right lobe of the liver. In his medical history, in April, after a seemingly harmless infestation of body lice, effectively treated, he suffered from a prolonged and debilitating episode of acute diarrhea, lasting a month. This status was also accompanied by intestinal cramps, weight loss, and recurring fever episodes. Afterwards also appeared a Quincke’s-like angioedema involving the lips and mouth mucosa, with evening time exacerbation. Conclusions: The differential diagnosis of this complex and unusual clinical picture, together with the temporal evolution of the patient’s signs and symptoms, led us to hypothesize the presence of concomitant infections. These were most likely borreliosis and a STE disease, the latter ultimately diagnosed as amebiasis with hepatic invasion, allowing appropriate treatment and a favorable clinical outcome.
Leishmaniasis is an endemic parasitic disease with significant global impact; World Health Organization (WHO) estimates indicate that over 12 million people are infected, predominantly in underdeveloped and developing tropical countries. The disease is caused by protozoa of the genus *Leishmania*, transmitted by female phlebotomine sandflies. Clinically, it manifests in three main forms: cutaneous (the most prevalent), mucocutaneous, and visceral (associated with high fatality rates). Conventional therapies face critical challenges regarding toxicity, parasite resistance, high costs, and variable efficacy. This narrative literature review, based on studies indexed in PubMed, synthesizes current treatment guidelines and innovations under development, as well as epidemiological control strategies. The findings underscore the need for integrated, multidisciplinary interventions that combine vector control with advances in natural and nanotechnology-based therapies, aiming to optimize the management of this neglected zoonosis.
Cutaneous leishmaniasis (CL) is a neglected tropical disease (NTD) traditionally associated with rural poverty in endemic regions but is increasingly encountered among international travelers, migrants, and displaced populations. Climate change, globalization, and mass human mobility have altered the epidemiology of CL, expanding the geographic range of competent vectors and increasing the burden of imported disease in non-endemic countries. Imported cases are of particular public health importance because they may serve as sentinels for autochthonous transmission in regions where vectors and reservoir hosts are present. This narrative review synthesizes surveillance data and epidemiological evidence on imported cutaneous and mucocutaneous leishmaniasis (MCL), with particular emphasis on findings from regional and global surveillance networks. We describe demographic, clinical, and travel-related patterns of imported disease, highlight differences between Old World and New World CL, and discuss implications for surveillance, clinical management, and future research in the context of climate change and global migration.