Infectious disease that leads not only to cutaneous manifestation but also to sepsis.
Occurs only in the high mountain valleys (600-3000m) of Peru, Ecuador and southwest Colombia.
It is expected that about 5% of the population of the endemic area are asymptomatic carriers.
Pathogen: Bartonella bacilliformis.
Transmission: Sand flies of Lutzomyia spp., especially Lutzomia verrucarum.
The transfer takes place during the sucking cycle and after blood transfusions.
Incubation period: weeks - months.
Bartonella bacilliformis causes both dermal nodules (Verruga peruana) and sepsis (Oroya fever).
Cutaneous manifestation includes stemmed, cruciform, grouped and eroded papules and nodi. The face, extremities and mucous membranes are particularly affected. Petechial exanthema.
Sepsis, reduced general condition, fever, anemia, hepatosplenomegaly, lymphadenopathy
A second infection with salmonella can occur.
Travel history.
Clinic.
Detection of pathogens by blood culture or biopsy.
Similar to bacillary angiomatosis.
The detection of bacteria is successful by means of warthin-starry staining.
Letality: 10-90%.
The survivors heal spontaneously, often after years of existence.
Blood work, liver and kidney function, clotting.
Blood culture.
Transfer to an intensive care unit for sepsis symptoms.
Vital parameter monitoring.
Chloramphenicol i.v. 25-30 mg/kg KG (max. 2g), 50-60 mg/kg bw (max. 4g daily) in 4 single doses.
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