Bartonellosis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
Symptoms
- Bartonellosis is usually characterized by an acute stage with primarily vascular effects and a chronic stage associated with 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 cells (i.e., hemolytic anemia). The acute phase typically lasts two-to-four weeks.
- Peripheral blood smears 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.
- The chronic manifestation—Verruga Peruana—consists of a benign skin eruption with raised, reddish-purple nodules (angiomatous tumours). Visualization is possible using a silver stain (the Warthin–Starry method).