Short report: verruga peruana in an Italian traveler from Peru

We report a case of cutaneous bartonellosis in a 24-year-old Italian woman. Soon after returning from a seven-month stay in a central area of Peru at an altitude of 3,130 meters, she developed high fever, headache, and muscle and joint pain that resolved after antibiotic therapy. Two months later, she presented with disseminated, painless, firm, purple, subcutaneous nodules on the neck, shoulders, legs, left eyelid, and hard palate, some of which developed into vegetating lesions. The diagnosis of bartonellosis was made on the basis of the clinical picture, the patient's medical history, the incubation period, the confirmatory histopathologic findings, and the response to treatment with chloramphenicol (500 mg four times a day for 14 days).