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1994-01-17
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$Unique_ID{BRK03515}
$Pretitle{}
$Title{Bartonellosis}
$Subject{Bartonellosis Bartonella Bacilliformis Infection Carrion's Disease
Oroya Fever Verruga Peruana Hemorrhagic Pian}
$Volume{}
$Log{}
Copyright (C) 1986 National Organization for Rare Disorders, Inc.
123:
Bartonellosis
** IMPORTANT **
It is possible that the main title of the article (Bartonellosis) is not
the name you expected. Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Bartonella Bacilliformis Infection
Carrion's Disease
Including:
Oroya Fever
Verruga Peruana (also known as Hemorrhagic Pian)
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section.
Bartonellosis is a bacterial infection characterized by anemia and high
fever and/or a chronic skin rash often accompanied by pain or fever. The
disease is found only in South America. A night biting sandfly transmits the
bacterium from one host to another. In untreated patients, the disease may
be fatal, but antimicrobial treatment cures it.
Symptoms
The first symptoms of Bartonellosis often constitute a syndrome known as
Oroya fever, and include abrupt onset of fever, weakness, pallor, headache,
muscle and joint pain, and in some cases, coma or delirium. They result from
invasion of the bloodstream by the causative bacterium, which attaches itself
to the surface of red blood cells, causing anemia and obstructed capillaries
by entering the cells lining them. Mortality in untreated cases of Oroya
fever can be very high.
This disease often occurs in patients who already have other infections
such as salmonella, amoebas, or malaria. The illness is more severe and life
threatening in such cases.
If the patient survives this acute stage of the infection, bacteria
appear in the skin and subcutaneous tissues after a latent period, reflecting
a different stage of immune reaction. The resulting skin condition is called
verruga peruana and is characterized by small nodular or pitted (eroding)
lesions that occur as a rash on the face and limbs. This rash may take
months or years to disappear, and can be accompanied by pain and fever.
Verruga peruana may appear in patients who have not had Oroya fever.
Causes
Bartonellosis is caused by the bacterium Bartonella bacilliformis. This
microorganism enters red blood cells and the cells lining the capillaries in
the Oroya fever stage of the illness. When it succumbs to the host's immune
defenses in these parts of the body, it emerges in the skin and subcutaneous
tissues causing verruga peruana.
Affected Population
The disease occurs only at certain altitudes in the Andes in South America.
(It is restricted to the range of the insect that transmits it.)
Therapies: Standard
Antimicrobial therapy, preferably with chloramphenicol, controls Oroya fever
and speeds healing of skin lesions. Severe anemia may require blood
transfusions.
Avoiding sandfly stings prevents Bartonellosis. Insect repellents, bed
nets and the use of long acting insecticides can accomplish this.
Therapies: Investigational
This disease entry is based upon medical information available through
September 1989. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Bartonellosis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Allergy and Infectious Diseases
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
Centers for Disease Control (CDC)
1600 Clifton Road, NE
Atlanta, GA 30333
(404) 639-3534
References
CECIL TEXTBOOK OF MEDICINE, 18th ed.: James B. Wyngaarden, and Lloyd H.
Smith, Jr., Eds.: W. B. Saunders Co., 1988. Pp. 924, 1681-2.
THE MERCK MANUAL 15th ed: R. Berkow, et al: eds; Merck, Sharp & Dohme
Research Laboratories, 1987. P. 111.