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Bartonellosis (Carrión's disease) in the modern era
C Maguina1, P J Garcia, E Gotuzzo
1Alexander von Humboldt Institute of Tropical Medicine, Universidad Peruana Cayetano, Heredia, Lima, Peru.
Abstract:
Bartonellosis remains a major problem in Peru, but many contemporary aspects of this disease have not been adequately described. We examined the cases of 145 symptomatic patients in Lima, Peru, in whom bartonellosis was diagnosed from 1969 through 1992, including 68 patients in the acute (hematic) phase and 77 patients in the eruptive (verruga) phase. In modern Peru, symptomatic patients who have acute-phase bartonellosis typically present with a febrile illness and systemic symptoms caused by profound anemia; most patients respond successfully to treatment with chloramphenicol. Patients who have eruptive-phase bartonellosis most often present with cutaneous verrugas but may have less specific symptoms, such as fever and arthralgias; diagnosis can be confirmed in such patients by Western immunoblotting, and most patients appear to respond to treatment with rifampin.
Insights
Bartonellosis in Peru presents distinct acute and eruptive phases. Acute cases show fever and anemia, responding to chloramphenicol, while eruptive cases feature skin lesions and may improve with rifampin.
Area of Science:
- Infectious Diseases
- Medical Microbiology
- Public Health
Background:
- Bartonellosis is a significant health concern in Peru.
- Contemporary aspects of bartonellosis in Peru require further description.
Purpose of the Study:
- To describe contemporary aspects of bartonellosis in symptomatic patients in Lima, Peru.
- To differentiate clinical presentations and treatment responses between acute and eruptive phases of bartonellosis.
Main Methods:
- Retrospective analysis of 145 symptomatic bartonellosis cases diagnosed in Lima, Peru, between 1969 and 1992.
- Categorization of patients into acute (hematic) and eruptive (verruga) phases.
- Review of clinical presentations, diagnostic methods, and treatment outcomes.
Main Results:
- The study included 68 patients in the acute phase and 77 in the eruptive phase.
- Acute-phase bartonellosis typically presented with febrile illness and anemia; chloramphenicol was an effective treatment.
- Eruptive-phase bartonellosis often manifested as cutaneous verrugas, with diagnosis confirmed by Western immunoblotting; rifampin appeared effective.
Conclusions:
- Bartonellosis in Peru exhibits distinct clinical phases with different management strategies.
- Acute bartonellosis is characterized by systemic symptoms and responds well to chloramphenicol.
- Eruptive bartonellosis, marked by skin lesions, can be diagnosed via Western immunoblotting and may be treated with rifampin.