Infection with Burkholderia mallei (formerly Pseudomonas mallei) can cause a subcutaneous
infection known as "farcy" or can disseminate to condition known as
Glanders. It is primarily a disease affecting horses, donkeys and mules. In humans,
Glanders can produce four types of disease: localized form, pulmonary form,
septicemia, and chronic form.
Necrosis of the tracheobronchial tree and pustular skin lesions characterize acute
infection with B. mallei. Other symptoms include febrile
pneumonia, if the organism was inhaled, or signs of
sepsis and multiple
abscesses, if the skin was the port of entry.
Glanders is endemic in Africa, Asia, the Middle East, and Central and South America.
Glanders has low contiguous potential, but because of the efficacy of aerosolized dissemination and the lethal nature of the disease, B. mallei was considered a candidate for biological warfare. During World War I,
Glanders was believed to have been spread to infect large numbers of Russian horses and mules on the Eastern front. The Japanese infected horses, civilians and prisoners of war during World War II. The USA and the Soviet Union have shown interest in B. mallei in their biological warfare program. The treatment is empiric and includes mono or poly-
therapy with
Ceftazidime,
Sulfadiazine, Trimethoprim + Sulfamethoxazol,
Gentamicin,
Imipenem etc. Aggressive control measures essentially eliminated
Glanders from the west. However, with the resurgent concern about biological warfare, B. mallei is now being studied in a few laboratories worldwide. This review provides an overview of the disease and presents the only case reported in the western world since 1949.