73 - Bartonellosis: Carrion's Disease and Other Bartonella Infections

Abstract

Carrion's disease, or South American bartonellosis, is a bi-phasic, arthropod-borne bacterial infection caused by the fastidious, intracellular, gram-negative bacterium Bartonella baciliformis. Other new Bartonella spp., including B. rochalimae and B. ancashensis, have been diagnosed in patients with a similar presentation to Carrion's disease. South American bartonellosis is transmitted by the bite of a sandfly (Lutzomyia spp.) that lives in the inter-Andean valleys (between 500 and 3200 meters above sea level) of Peru, Colombia, and Ecuador. Classically, it presents initially as an acute febrile-hemolytic stage (Oroya fever) and then as a chronic cutaneous illness (verruga peruana). Oroya fever is a life-threatening condition characterized by fever, pallor, and hemolytic anemia. Verruga peruana is a benign and prolonged stage distinguished by erythematous skin lesions. Other relevant diseases caused by Bartonella species include cat scratch disease, trench fever, bacillary angiomatosis, and blood culture–negative endocarditis.