HUMAN GLANDERS: REPORT OF SIX CASES

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Abstract
Six cases of glanders occurring in laboratory workers are described in detail. Five patients contracted focal pulmonary lesions, and the 6th patient showed evidence of acute splenitis and/or perisplenitis. Malleomyces mallei, the causative organism of glanders, was not isolated in any case. The specific diagnosis was based on a significant rise in serum ag-glutinin titer for M. mallei in all 6 cases; on positive complement-fixation for M. mallei in 4 cases; and on positive mallein skin tests in 5 cases. All of these observations were adequately controlled with extensive serologic studies on normal subjects, who failed consistently to show significant agglutination or complement-fixation titers, and who showed no reaction to commercial mallein given intradermally. Because of its demonstrated efficacy in curing hamsters infected experimentally with M. mallei, sulfadiazine in full dosage over a 10- to 20-day period was given to all 6 patients in this series at different stages of disease. Two patients showed a definite clinical response to chemotherapy; the remaining 4 patients were in various stages of recovery when treatment was initiated.
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