Davao Doctors College

Department of Medical Laboratory Science

CLINICAL HEMATOLOGY 1

BARTONELLOSIS

HISTORY EPIDEMIOLOGY

 1875- (Oraya Fever)  Carrion's disease is found only in:

 1885- Daniel A. Carrion (Perruvian Wart)  Peru,
 1905-Dr. Alberto Leonardo Barton Thompson  Ecuador, and
discovered the etiologic agent of “Carrion's disease”  Colombia

DEFINITION  It is endemic in some areas of Peru and is caused by

infection with the bacterium Bartonella bacilliformis and
 The human Bartonellosis "Carrion's disease" or "Peruvian transmitted by sandflies of genus Lutzomyia.
wart" is an infectious disease caused by a bacterium
Bartonella bacilliformis, which parasitizes red blood cells DIFFERENTIAL DIAGNOSIS
from human blood.
A health care provider diagnoses bartonellosis based
SIGNS & SYMPTOMS on:
FIRST STAGE (ACUTE PHASE)
 a medical history
 Hemolytic anemia
 Jaundice Taking a medical history is one of the first things a health care
 Pallor provider may do to diagnose bartonella.
 Nonpainful hepatomegaly  a physical exam
 Malaise A physical exam may help diagnose anemia.
 Lymphadeopathy
 blood tests
SECOND STAGE (CHRONIC PHASE) which measures the type and number of blood cells in the
 Splenomegaly body.
 Arthralgias
 Myalgias TREATMENT

Depending on the cause, a health care provider treats anemia

ETIOLOGY with one or more of the following treatments:
 Causative agent: proteobacteria Bartonella bacilliformis
 Main vector: female of the mosquito sandfly (Lutzomyia ACUTE STAGE TREATMENT
verrucarum)
 Transmission routes:  CHLOR AMPHENICOL
-By the bite of the mosquito - Antimicrobial agent as a beta lactam.
-Transfusion with infected blood - For the effective treatment of B. bacilliformis and
protect against any secondary bacterial infection.
PATHOGENESIS
CHRONIC STAGE TREATMENT
 The transmission of Bartonella species is with contact of
animals and vectors  CIPROFLOXACIN,
 B.bacilliformis, which uses a polar flagellum  TETRACYCLINE
 Adheres to and invades RBCs.  ERYTHROMYCIN
 Rifampin
 Streptomycin
Possible Ponsequences IF NOT TREATED:

 If the infection is not treated, the mortality rate can be as

high as 85%.
 Purple thrombocytopenic- Complication Hematologic
recently reported that may occur with evolution
favorable.
 Complications have been reported neurological
 Acute hemolysis-Associated with fever, Parasitized
erythrocytes bartonellosis

Bartonellosis Diagnostics Test

 Reaction Polymerase Chain

 Blood smears stained with Giemsa
 Agar cultures and Cell cultures.
 Indirect fluorescent antibody test
 Western blot

REMEMBER!
 Human bartonellosis is bacterial infection by the genus
bartonella
 Bartonellosis caused by B. bacilliformis endemic in Peru,
Ecuador and columbia.
 Suspected vector: phlebotomine sand flies (Lutzomyia
verrucarum)
 About the disease, there are two classical clinical
presentation: acute and chronic phase.
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