There are two stages of B. bacilliformis infection. The initial stage is Oroya fever, a serious infectious anemia. The second is the eruptive stage, verruga peruana, which commonly begins 2–8 weeks later, although verruga may also occur in the absence of Oroya fever.

Oroya fever is characterized by the rapid development of severe anemia caused by the red blood cell destruction, enlargement of the spleen and liver, and hemorrhage into the lymph nodes. Masses of bartonellae fill the cytoplasm of cells lining the blood vessels, and endothelial swelling may lead to vascular occlusion and thrombosis. The mortality rate of untreated Oroya fever can be as high as 85%. The diagnosis is made by examining stained blood smears and blood cultures in semisolid medium.

Weeks to months following acute infection, a second stage of infection called verruga peruana, characterized by vascular nodular skin lesions that occur in successive crops, appears. This infection lasts for about 1 year and produces little systemic reaction and no fatalities. Mucosal and internal lesions have been described. Bartonellae can be seen in the granulomas; blood culture results are often positive, but there is no anemia.

B. bacilliformis produces an extracellular protein called deformin that promotes deformity (indentation) of red blood cell membranes, and flagella provide the organisms with the mechanical force to invade red blood cells. Replication of the organism occurs within an endocytic vacuole facilitated by outer membrane proteins and erythrocyte membrane fragments created at the time of attachment and membrane deformity. B. bacilliformis also invades endothelial cells and other types of human cells in vitro.

Bartonellosis is limited to the mountainous areas of the American Andes in tropical Peru, Colombia, and Ecuador, and is transmitted by sandflies of the genus Lutzomyia.

B. bacilliformis grows in semisolid nutrient agar containing 10% rabbit serum and 0.5% hemoglobin. After 10 days or more of incubation at 28°C, turbidity develops in the medium, and rod-shaped and granular organisms can be seen in Giemsa-stained smears.

Ciprofloxacin, doxycycline, macrolides, or sulfamethoxazole–trimethoprim given for at least 10 days has been used to successfully treat patients. Parenteral therapy can be used if the patient is unable to absorb oral medication. Chloramphenicol for 14 days has been used to effectively treat B. bacilliformis infections particularly in South America. Coupled with blood transfusions, when indicated, antimicrobial therapy greatly reduces the mortality rate. Control of the disease depends on elimination of the sandfly vectors; insecticides, insect repellents, and elimination of sandfly breeding areas are of value. Prevention with antibiotics may be useful

اخر الاخبار

اخبار العتبة العباسية المقدسة

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المزيد

الآخبار الصحية

هل يتنبأ الذكاء الاصطناعي بأمراضنا قبل حدوثها؟

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المزيد

الآخبار التكنلوجية

أول قطار يعمل بالهيدروجين في أميركا يدخل الخدمة رسميًا

أجهزة أبل القادمة.. "حصن منيع" في عصر الهجمات الرقمية !

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ميزة ثورية.. أبل تدخل عالم قياس ضغط الدم

المزيد

مواضيع ذات صلة

Bartonella henselae and Bartonella quintana

Legionella pneumophila and other Legionellae

Pathogenesis of Anaerobic Infections

Coxiella

Rickettsia, Orientia, Anaplasma, and Ehrlichia

Chlamydia pneumonia

Urinary Tract Infections

Actinomyces

Neisseria meningitidis

The Brucellae

Diagnostic Laboratory Tests of Bordetella pertussis

Chlamydia psittaci