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Bartonella bacilliformis infection 

Bartonella bacilliformis infection

Chapter:
Bartonella bacilliformis infection
Author(s):

A. Llanos-Cuentas

and C. Maguiña-Vargas

DOI:
10.1093/med/9780199204854.003.070643_update_001

Update:

Molecular taxonomy—multilocus sequence typing of Peruvian isolates revealed wide genetic diversity.

Clinical features—new syndromes.

Diagnosis—sensitivity and specificity of blood smear detection.

Updated on 31 May 2012. The previous version of this content can be found here.
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date: 24 April 2017

Bartonellosis (Carrión´s disease, verruga Peruana, Oroya fever, Guaitará fever) is caused by the Gram-negative bacillus Bartonella bacilliformis. It is endemic in the western Andes and inter-Andean valleys of Peru, and is still occasionally reported in Ecuador, with infection resulting from the bite of various female sandflies.

Clinical features, diagnosis, management, prognosis and prevention—infection of red blood cells manifests with nonspecific ‘viral-type’ symptoms and haemolytic anaemia in the acute stage of disease. Following an asymptomatic phase, the late ‘eruptive’ stage is characterized by dermal nodules (‘verrugas’) that frequently heal spontaneously. Secondary opportunistic infections are common. Diagnosis in areas where the disease occurs is usually by demonstration of bacteria in the blood film. Ciprofloxacin is the treatment of choice in most cases. Mortality is 1.1 to 2.4% in endemic areas and around 9% in patients admitted to hospital. There is no satisfactory prevention for people living in endemic areas; tourists can take the usual precautions against being bitten by insects.

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