Bartonellosis

Last Updated: 2019-08-27

Author(s): Anzengruber F., Navarini A.

ICD11: -

  • Odriozola 1895.
  • Barton 1909.
  • Verruga peruana.
  • Carrion’s disease.
  • Oroya fever.

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.
  • Alternative: Doxycycline p.o. 100 mg 2x daily
  • Alternatively: Erythromycin p.o. 500 mg 3x daily, maximum dose: 4 g/d (adults). 
  1. Angelakis E , Raoult D. Pathogenicity and treatment of Bartonella infections. Int J Antimicrob Agents 2014;44:16-25.
  2. Breitschwerdt EB. Bartonellosis: one health perspectives for an emerging infectious disease. ILAR J 2014;55:46-58.
  3. Bai Y, Malania L, Alvarez Castillo D, Moran D, Boonmar S, Chanlun A et al. Global distribution of Bartonella infections in domestic bovine and characterization of Bartonella bovis strains using multi-locus sequence typing. PLoS One 2013;8:e80894.
  4. Prutsky G, Domecq JP, Mori L, Bebko S, Matzumura M, Sabouni A et al. Treatment outcomes of human bartonellosis: a systematic review and meta-analysis. Int J Infect Dis 2013;17:e811-9.
  5. Edouard S, Nabet C, Lepidi H, Fournier PE , Raoult D. Bartonella, a common cause of endocarditis: a report on 106 cases and review. J Clin Microbiol 2015;53:824-9.
  6. Fleischman DA, Chomel BB, Kasten RW, Andre MR, Goncalves LR , Machado RZ. Bartonella clarridgeiae and Bartonella vinsonii subsp. berkhoffii exposure in captive wild canids in Brazil. Epidemiol Infect 2015;143:573-7.