The clinicians can suspect for melioidosis when the patients present with fever along with the history of travelling to endemic areas where melioidosis is predominant; any contact with soil or water that contain Burkholderia pseudomallei; and the presence of risk factors such as diabetes mellitus, kidney or liver disease (Limmathurotsakul and Peacock, 2011).

The current gold standard for definitive diagnosis of melioidosis is bacterial identification by culture from the specimens such as blood, sputum and other clinical samples. This method has several drawbacks like, it requires enrichment followed by several days of incubation and this result in the delay of administering antibiotics to the patients (Limmathurotsakul et al., 2010); and moreover it is difficult to identify the organism from the culture contaminants and B. pseudomallei develop resistance to most of the antibiotics used in the empirical therapy (O'Brien et al., 2004). Therefore, in order to speed up the diagnosis, various nucleic acid detection tests, antigen detection tests and serology assays can be performed which provide the results rapidly when compared to the classical culturing method.

The sensitivities of both direct immunofluorescent technique and rapid immunofluorescent technique were 66 % and specificities were 99.4 % and 99.5 % respectively (Wuthiekanun et al., 2005). The latter afford the specific results in 10 min (Wuthiekanun et al., 2005) whereas the former provides in 2 hours (Walsh et al., 1994). A study reported that the indirect immunofluorescent antibody test may be useful for the rapid diagnosis of the disease and their results shows that the negative predictive value of IgM assay was 92 % whereas the positive predictive value was 100 % when both IgM and IgG consider together (Mathai et al., 2003).

The indirect haemagglutination assay (IHA) is widely used but it lacks sensitivity. A study suggests that approximately half of the patients diagnosed to have the disease by culture method but it detected by IHA (Ashdown, 1987). This resulted in the development of other serology assay like enzyme linked immunosorbent assay (ELISA) and immuno Polymerase Chain Reaction (PCR). These assays can detect the antibodies of B. pseudomallei (Cooper, 2013). The Immunochromatographic test (ICT) IgG kits can be employed to diagnose melioidosis in the patients who travel the endemic areas of melioidosis (O'Brien et al., 2004).

Therefore, the diagnosis can be done at the earliest by using both culture method with one of the above mentioned serological assays as the condition of patient may worsen when there is delay in diagnosis after the clinical presentation.