Bartonellosis. An immunodepressive disease and the life of Daniel Alcides Carrión

The history of human Bartonellosis, a unique South American biphasic bacterial disease, is reviewed. The course of this disease and its natural history offer many puzzling problems. Its geographic distribution, its absence of a natural reservoir, the development of transient immunosuppression during the acute hematic phase, and the subsequent development of vascular proliferations are highlighted. These vascular proliferations represent a unique example of tissue reactivity recalling the vascular proliferations of patients with AIDS. In addition, the authors review the life and times of Daniel Alcides Carrión, a Peruvian medical student who in 1885 by self-experimentation linked both phases of the disease and died in doing so. Carrión's life, and the impact of his experiment on the subsequent study of Bartonellosis by Peruvian and international scholars, epitomize the constant struggle of the Peruvian medical profession (past and present) to upgrade domestic biomedical research and to find a national identity.