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| {{Infobox_Disease |
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| | {{About1|Bartonella}} |
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| | '''For patient information, click [[Bartonellosis (patient information)|here]]''' |
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| | {{Bartonellosis}} |
| DiseasesDB = 1249 |
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| ICD10 = A44 |
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| ICD9 = {{ICD9|088.0}} |
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| eMedicineSubj = med |
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| eMedicineTopic = 212 |
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| MeshID = D001474 |
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| {{CMG}} | | {{CMG}} |
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| {{Editor Help}} | | {{SK}} Bartonella infection, Guaitara fever, Rochalimaea infection |
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| '''''Synonyms and Key Words:''''' Carrion's disease or Oroya fever
| | ==[[Bartonellosis overview|Overview]]== |
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| '''Bartonellosis''' a rare [[infectious disease]] found only in certain regions of the Andes mountains of South America. [[Endemic (epidemiology)|Endemic]] in some areas of Peru,<ref>{{cite journal | author = Maco V, Maguiña C, Tirado A, Maco V, Vidal JE | title = Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru | journal = Rev. Inst. Med. Trop. Sao Paulo | volume = 46 | issue = 3 | pages = 171-4 | year = 2004 | pmid = 15286824 | doi = /S0036-46652004000300010}}</ref> bartonellosis is caused by infection with the [[bacterium]] ''[[Bartonella bacilliformis]]'' and transmitted by sandflies of [[genus]] ''[[Lutzomyia]]''. Bartonellosis has been recently found in the United States as well as in Canada.
| | ==[[Bartonellosis historical perspective|Historical Perspective]]== |
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| ==Pathophysiology== | | ==[[Bartonellosis pathophysiology|Pathophysiology]]== |
| Bartonellosis is usually characterized by an [[Acute (medical)|acute]] stage with primarily [[blood vessel|vascular]] effects and a [[chronic (medicine)|chronic]] stage associated with [[dermatology|skin]] symptoms. In the acute stage (also known as Oroya fever or ''Fiebre de la Oroya''), bartonellosis is a sudden, potentially life-threatening illness associated with high [[fever]] and decreased levels of circulating [[red blood cell]]s (i.e., [[hemolytic anemia]]). The acute phase typically lasts two-to-four weeks. [[Peripheral blood smear]]s shows anisomacrocytosis with many [[bacilli]] adherent to [[red blood cells]]. [[Thrombocytopenia]] is also seen and can be very severe. Neurologic involvement is sometimes seen (neurobartonellosis) and the [[prognosis]] in this case is very guarded. It can present as spinal [[meningitis]] or as [[paralysis]]. In the acute stage, the most feared complication is [[fulminant]] ''[[Salmonella]]'' [[superinfection]]: for this reason [[chloramphenicol]] is the preferred antibiotic treatment.
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| The chronic manifestation—''Verruga Peruana''—consists of a [[benign]] skin eruption with raised, reddish-purple [[nodule]]s ([[angioma|angiomatous tumours]]). Visualization is possible using a [[silver stain]] (the Warthin–Starry method).
| | ==[[Bartonellosis causes|Causes]]== |
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| Untreated, bartonellosis has a death rate of about 40%.
| | ==[[Bartonellosis differential diagnosis|Differentiating Bartonellosis from other Diseases]]== |
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| ==History== | | ==[[Bartonellosis epidemiology and demographics|Epidemiology and Demographics]]== |
| The disease was named after Dr. Alcides Carrión of Cerro de Pasco, Peru. Carrión described the disease after being infected on his request by Doctor Evaristo M. Chávez, a close friend and coworker in Dos de Mayo National Hospital. Carrión kept a meticulous clinical history until he was not able to do so because of the high fever. Carrión proved that "Fiebre de la Oroya" and "Verruga Peruana" were two stages of the same disease, not two different ones as thought at the time.
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| Dr Carrion had infected himself from the pus in the purple lesion in a bart No. 1 subspecies (bartonellosis) patient in 1885. He died from the disease several weeks later. Bart "1" is considered the most deadly bart to date..rarely killing in late chronic stage but in early stage some studies show a death rate of up to 90%. He was able to show the 2 disease stages where in fact 1 sole disease. He gave his life for us, and it led to the discovery of many more (23 subspecies to date) of bartonella. Although his work didn't save anyone at that time, he surely got the ball rolling. On his honor, we shall be forever grateful for his efforts on this disease.
| | ==[[Bartonellosis risk factors|Risk Factors]]== |
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| The causative bacterial agent of bartonellosis was discovered by Alberto Barton in 1905, but it was not published until 1909. Barton originally identified them as endoglobular structures, which actually were the bacteria living inside red blood cells. Until 1993, the ''Bartonella'' [[genus]] contained only one species; there are now 23 identified species, all of them within family Bartonellaceae.<ref>{{cite journal | author = Zeaiter Z, Liang Z, Raoult D | title = Genetic classification and differentiation of Bartonella species based on comparison of partial ftsZ gene sequences | journal = J. Clin. Microbiol. | volume = 40 | issue = 10 | pages = 3641-7 | year = 2002 | pmid = 12354859 | doi = }}</ref>
| | ==[[Bartonellosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==References== | | ==Diagnosis== |
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| {{Reflist}}
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| ==External links== | | [[Bartonellosis history and symptoms|History and Symptoms]] | [[Bartonellosis physical examination|Physical Examination]] | [[Bartonellosis laboratory findings|Laboratory Findings]] | [[Bartonellosis other diagnostic studies|Other Diagnostic Studies]] |
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| | ==Treatment== |
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| | [[Bartonellosis medical therapy|Medical Therapy]] | [[Bartonellosis primary prevention|Primary Prevention]] | [[Bartonellosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bartonellosis future or investigational therapies|Future or Investigational Therapies]] |
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| | ==Case Studies== |
| | [[Bartonellosis case study one|Case #1]] |
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| | ==External Links== |
| * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11512081&dopt=Abstract Bartonellosis (Carrion's disease) in the modern era] | | * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11512081&dopt=Abstract Bartonellosis (Carrion's disease) in the modern era] |
| * [http://www.biology-online.org/dictionary/carrions_disease Oroya fever]
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