Bartonella bacilliformis: Difference between revisions
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Bartonella bacilliformis
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===Epidemiology=== |
===Epidemiology=== |
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* Range is essentially restricted to the Andean mountains in Peru, Ecuador, and Colombia |
* Range is essentially restricted to the Andean mountains in Peru, Ecuador, and Colombia |
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* Transmitted by ''[[ |
* Transmitted by ''[[Vector::Lutzomyia]]'' sand flies |
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* Humans are primary reservoir |
* Humans are primary reservoir |
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==Clinical |
==Clinical Manifestations== |
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* Traditionally presents as a biphasic illness with an acute phase ('''Oroya fever''') and a late phase ('''verruga peruana''') |
* Traditionally presents as a biphasic illness with an acute phase ('''Oroya fever''') and a late phase ('''verruga peruana''') |
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* 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 |
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** May only last a week and not present for medical care |
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** More severe disease can include high fever, chills, diaphoresis, anorexia, prostration, headache, and altered mental status |
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** The anemia can be profound in severe disease |
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** 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 |
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** Severe disease has high mortality if untreated, but decreases to 10% if treated |
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** Crops of lesions proceed from miliary, to nodular, to mulaire lesions |
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** Mulaire lesions are superficial vascular bulbous lesions that can bleed and ulcerate |
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** Lesions can also be internal |
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** Lesions can come and go, with recurrences, over weeks to months |
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==Diagnosis== |
==Diagnosis== |
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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
