Glanders

Glanders is an infectious disease caused by Burkholderia mallei, primarily affecting equids (horses, mules, donkeys). Humans are infected by contact with sick animals or contaminated objects. It presents as acute fever with cellulitis, necrosis, abscesses, and granulomas of the respiratory tract, skin, and muscles; some cases are chronic and relapsing for years. Aristotle recorded it in 330 BC, naming it Malleus (Latin for malignant). Royer first described human glanders in 1837; Löffler and Schütz isolated the pathogen in 1882; it was named Pseudomonas mallei in 1985.

Common Symptoms

Lymphadenopathy; blood-streaked purulent nasal discharge; diarrhea; oral mucosal ulcer; black nasal discharge; nasal septum perforation; septicemia; low fever

Causes and Pathogenesis

(1) Etiology: Burkholderia mallei has been reclassified several times (Loefflerella, Actinobacillus, Achromobacter, Pseudomonas, now Burkholderia in 1993). It is a slightly curved rod 2-5 × 0.5-1.0 µm, mostly single, non-motile, non-encapsulated, non-spore-forming, Gram-negative; aerobic, optimal at 37-38°C, pH 6.8-7.0; grows poorly on ordinary media but well in 1-5% glycerol broth, forming a yellowish honey-like film on potato that turns brown-red; growth takes 48 h; S colonies become R/C/D/M/P variants. It must be distinguished from B. pseudomallei. It has specific polysaccharide and shared protein antigens (cross-reacting with melioidosis); no exotoxin, but intracellular endotoxin protein (mallein) causes allergy and is used as a skin-test antigen. It survives 4 h in feces/urine, 70 days in water, 6 months in sterilized tap water, 10-15 days dry, killed by 24 h sunlight, 56°C/15 min, instantly by boiling, 1 h in 3% cresol/10% lime/2% formalin. (2) Pathogenesis: Mainly contact transmission via broken skin/mucosa, also respiratory/digestive infection.

Treatment

Drug therapy, supportive therapy

Preventive Measures

1. Eliminate sources: eradicate equine glanders. (1) Detection: mallein eye-drop test; observe at 3, 6, 9, 24 h; conjunctivitis with purulent discharge is positive. (2) Isolation: divide horses into diseased, suspected, and presumed-healthy groups; observe suspected/presumed groups for 6 months; contact-negative horses still need 3 weeks' isolation. (3) Cull: confirmed infected horses are killed without bleeding and deeply buried regardless of symptoms. 2. Cut transmission: disinfect contaminated stables with chloride of lime; compost bedding/manure. 3. Protect susceptibles: educate horse workers; disinfect excreta; lab workers use aseptic technique; medically observe suspected contacts for 3 weeks; treat patients under strict isolation until cured.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.