The radiology of melioidosis.

Melioidosis varies from subclinical infection to fulminating disease with multiple organ involvement. Although endemic in South-East Asia and northern Australia, it may be imported into temperate zones. It is the wide spectrum of manifestation that makes it 'the great imitator'. The purpose of this pictorial essay is to familiarize the radiologist with the range of radiological manifestations of this disease. Intrathoracic findings include pulmonary nodules, consolidation, necrotizing lesions, pleural effusion, pleural thickening and mediastinal abscess. Abscess in almost all organ systems can be seen in the septicaemic and suppurative infections. Both clinical and radiological findings are non-specific. A high index of suspicion is required to focus the search for bacteriological confirmation. A prompt diagnosis is essential, as melioidosis is often rapidly fatal.