• Liesbeth Martine Kager, Tom van der Poll, and Willem Joost Wiersinga.
• Academic Medical Center, Center for Experimental and Molecular Medicine (CEMM), University of Amsterdam, Meibergdreef 9, Room G2-130,1105 AZ, Amsterdam, The Netherlands.
• Expert Rev Anti Infect Ther. 2014 Aug 1; 12 (8): 993-1002.

AbstractMelioidosis, caused by the Gram-negative bacterium Burkholderia pseudomallei, is a dreadful disease common in South-East Asia and Northern Australia and is characterized by chronic suppurative lesions and pneumonia. Melioidosis may evolve into severe sepsis with multi-organ failure with high mortalities, despite proper antibiotic therapy. Besides activation of a strong pro-inflammatory host response, the coagulation system plays an important role during melioidosis, which is thought to be host-protective. In particular, a procoagulant state together with downregulation of anticoagulant pathways and activation of fibrinolysis are present, all closely interrelated with parameters of inflammation. This review presents an overview of recent studies in which the role of coagulation, anti-coagulation and fibrinolysis during melioidosis was investigated both in patients and in experimental settings.

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