title: Pathological findings and diagnostic implications of a rhesus macaque (Macacca mulatta) model of aerosol exposure to Burkholderia mallei (glanders).
abstract: Burkholderia mallei is a Gram-negative bacillus that causes a pneumonic disease known as glanders in equids and humans, and a lymphatic infection known as farcy, primarily in equids. With the potential to infect humans by the respiratory route, aerosol exposure can result in severe, occasionally fatal, pneumonia. Today, glanders infections in humans are rare, likely due to less frequent contact with infected equids than in the past. Acutely ill humans often have non-specific clinical signs and in order to diagnose cases, especially in scenarios of multiple cases in an unexpected setting, rapid diagnostics for B. mallei may be critical. The pathogenesis of acute glanders in the rhesus macaque (Macaca mulatta) was studied as an initial effort to improve diagnostic methods. In the study described here, the diagnostic techniques of PCR, culture and histopathology were compared. The results indicated that PCR may provide rapid, non-invasive diagnosis of glanders in some cases. As expected, PCR results were positive in lung tissue in 11/12 acutely infected rhesus macaques, but more importantly in terms of diagnostic algorithm development, PCR results were frequently positive in non-invasive samples such as broncho-alveolar lavage or nasal swabs (7/12) and occasionally in blood (3/12). However, conventional bacterial culture failed to recover bacteria in many of these samples. The study showed that the clinical presentation of aerosol-exposed rhesus macaques is similar to descriptions of human glanders and that PCR has potential for rapid diagnosis of outbreaks, if not individual cases.
authors: US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors: Samuel L
authors: SL
authors: Yingst
authors: US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors: Paul
authors: P
authors: Facemire
authors: Ordway Research Institute, Albany, NY, USA.
authors: Lara
authors: L
authors: Chuvala
authors: US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors: David
authors: D
authors: Norwood
authors: US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors: Mark
authors: M
authors: Wolcott
authors: Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA.|US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors: Louis
authors: L
authors: Huzella
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols / Q000008:administration & dosage*; D000818:Animals; D001431:Bacteriological Techniques / Q000379:methods; D042726:Burkholderia mallei / Q000254:growth & development*; D004195:Disease Models, Animal; D005896:Glanders / Q000175:diagnosis* / Q000473:pathology*; D006651:Histocytochemistry / Q000379:methods; D008253:Macaca mulatta; D025202:Molecular Diagnostic Techniques / Q000379:methods; D010336:Pathology / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D000336:Aerosols