Glanders

• Caused by Burkholderia (Pseudomonas) mallei
• Exists in eastern Europe and Asia
• Notifiable in UK
• Characterised by multiple small submucosal nasal nodules which liquefy and ulcerate
  • Cores of neutrophils surrounded by a rim of macrophages and granulation tissue
• In addition may have similar nodules in lungs, lymph nodes and cutaneous lymphatics
• Clinical signs: fever and head/ neck lymphadenitis, rhinitis

• Largely eradicated but sporadic cases in Middle East, India, China
• Pathogenesis:
  • Transmited by ingestion of food/water contaminated by nasal discharge of infected Equidae; occasionally via inhalation or skin wounds
  • Organism invades nasopharyngeal mucosa and spreads to other tissues via lymphatics
  • Presence of B. mallei in host causes hypersensitivity reaction
• Clinical infections:
  • Acute septicaemic form with fever, mucopurulent nasal discharge and respiratory signs; death within weeks
  • Chronic disease more common:
    • Nasal form: rhinitis; ulcerative nodules develop on mucosa of nasal septum and lower part of turbinates; purulent blood-stained nasal discharge; regional lymphadenitis
    • Respiratory form: respiratory distress; granulomatous lesions throughout lungs
    • Cutaneous form (farcy): lymphangitis; nodules along lymphatic vesselsof limbs; ulcers develop and discharge pus
    • May die after several months or recover and shed organisms from respiratory tract or skin
  • Carnivores may contract disease by eating infected carcasses
• Diagnosis:
  • Specimens include discharges from lesions and blood for serology
  • Grows on media containing 1% glycerol; most strains are non-lactose fermenters on MacConkey agar
  • Complement fixation and agglutination
  • Serology
  • Mallein test: mallein injected intradermally below lower eyelid; local swelling and discharge indicates positive reation
• Treatment/control:
  • Test and slaughter policy where disease exotic
  • Disinfection of contaminated areas using formalin or an iodophor