An infection of animals and humans caused by Burkholderia (B) (Pseudomonas [P], pseudomallei). The acute form causes pneumonia, multiple abscesses, septicemia, and possibly death.

The organism is found in soil and water, and occurs continually or in expected cycles in Southeast Asia; Australia; Central, West and East Africa; India; and China. Humans are infected through abrasions of the skin and burns. Ingesting or inhaling the organism can also cause infection.

The infection may remain latent for a number of years; however, it can occur without symptoms and in a variety of forms. The most common form is acute lung infection. It may progress to a severe pneumonia causing necrosis. Other manifestations include, headache; loss of appetite; dull, aching chest pain; fever; cough; tachypnea; rales; and blood-tinged sputum. Septicemia may also occur. The onset is likely to be abrupt in nature, resulting in septic shock, and multi- or single-organ involvement with various manifestations depending on the organ affected.

Laboratory tests for B. pseudomallei (P. pseudomallei) in laboratory media for hemagglutination, agglutination, and complement fixation assist in the diagnosis of the disease. Chest x-ray may be suggestive of tuberculosis (TB) in the absence of sputum associated with the TB organism.

Patients without symptoms are not treated. Mild and more severe cases are treated with antibiotics. The selected antibiotic and its dosage are dependent upon the severity of the disease.

The percentage of patients who die from this disease is less than 10% in acute cases. If septicemic infections result, long-term (30 to 120 days) antibiotic therapy is indicated.

1. This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under §3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of §3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], §3.309(a) [chronic disease].

2. May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% and/or other requirements/qualifications under 38 CFR §3.350 [Special monthly compensation ratings]. Also reference 38 CFR 3.155(d)(2).

• Confirm by culture or other specific diagnostic laboratory tests the initial diagnosis and any relapse or chronic activity of infection.

• Rate under the appropriate body system any residual disability of infection, which includes, but is not limited to, arthritis, lung lesions, or meningitis.