Bartonella bacilliformis: Difference between revisions

Latest revision as of 13:47, 5 August 2020

Background

Epidemiology

Range is essentially restricted to the Andean mountains in Peru, Ecuador, and Colombia
Transmitted by Lutzomyia sand flies
Humans are primary reservoir

Clinical Manifestations

Traditionally presents as a biphasic illness with an acute phase (Oroya fever) and a late phase (verruga peruana)
The acute phase starts after an incubation period of 3 to 12 weeks, and is characterized by fever, malaise, and a hemolytic anemia
- May only last a week and not present for medical care
- More severe disease can include high fever, chills, diaphoresis, anorexia, prostration, headache, and altered mental status
- The anemia can be profound in severe disease
- May be accompanied by severe myalgias and arthralgias, abdominal pain, emesis, jaundice, lymphadenopathy, thrombocytopenia, seizures, delirium, meningoencephalitis, obtundation, dyspnea, hepatic dysfunction, and angina, likely secondary to anemia and microvascular thrombosis
- Severe disease has high mortality if untreated, but decreases to 10% if treated
The late phase occurs weeks to months after the acute phase, and is characterized by disseminated nodular skin lesions
- Crops of lesions proceed from miliary, to nodular, to mulaire lesions
- Mulaire lesions are superficial vascular bulbous lesions that can bleed and ulcerate
- Lesions can also be internal
- Lesions can come and go, with recurrences, over weeks to months

Diagnosis

During acute phase, may see intraerythrocytic bacteria on blood film

@@ Line 2: / Line 2: @@
 ===Epidemiology===
 * Range is essentially restricted to the Andean mountains in Peru, Ecuador, and Colombia
-* Transmitted by ''[[Has vector::Lutzomyia]]'' sand flies
+* Transmitted by ''[[Vector::Lutzomyia]]'' sand flies
 * Humans are primary reservoir
-==Clinical Presentation==
+==Clinical Manifestations==
 * Traditionally presents as a biphasic illness with an acute phase ('''Oroya fever''') and a late phase ('''verruga peruana''')
-* The acute phase is characterized by fever, malaise, and a hemolytic anemia
+* The acute phase starts after an incubation period of [[Usual incubation period::3 to 12 weeks]], and is characterized by fever, malaise, and a hemolytic anemia
+** May only last a week and not present for medical care
-* The late phase is characterized by nodular skin lesions
+** More severe disease can include high fever, chills, diaphoresis, anorexia, prostration, headache, and altered mental status
+** The anemia can be profound in severe disease
+** May be accompanied by severe myalgias and arthralgias, abdominal pain, emesis, jaundice, lymphadenopathy, thrombocytopenia, seizures, delirium, meningoencephalitis, obtundation, dyspnea, hepatic dysfunction, and angina, likely secondary to anemia and microvascular thrombosis
+** Severe disease has high mortality if untreated, but decreases to 10% if treated
+* The late phase occurs weeks to months after the acute phase, and is characterized by disseminated nodular skin lesions
+** Crops of lesions proceed from miliary, to nodular, to mulaire lesions
+** Mulaire lesions are superficial vascular bulbous lesions that can bleed and ulcerate
+** Lesions can also be internal
+** Lesions can come and go, with recurrences, over weeks to months
 ==Diagnosis==
@@ Line 14: / Line 23: @@
 ==Management==
+{{DISPLAYTITLE:''Bartonella bacilliformis''}}