Oroya fever and verruga peruana are 2 distinct phases of infection caused by the gram-negative bacterium Bartonella bacilliformis. Oroya fever occurs after initial exposure; verruga peruana occurs after recovery from the primary infection. Diagnosis is clinical and confirmed by blood cultures (for Oroya fever) and sometimes by biopsy (for verruga peruana). Treatment is with antibiotics.
(See also Overview of Bartonella Infections.)
Endemic only to the Andes Mountains (at elevations of 600 to 2400 meters) in Colombia, Ecuador, and Peru, both Oroya fever and verruga peruana are passed from human to human by the Phlebotomus sandfly.
Oroya Fever
Symptoms of Oroya fever include fever and profound anemia, which may be sudden or indolent in onset. The anemia is primarily hemolytic, but myelosuppression also occurs. Muscle and joint pain, severe headache, and often delirium and coma may occur. Superimposed bacteremia caused by Salmonella or other coliform organisms may occur.
Diagnosis of Oroya fever is confirmed by blood cultures.
Because Oroya fever is often complicated by Salmonella1ciprofloxacin
Case fatality rates may exceed 50% in untreated patients.
Reference
1. Gomes C, Ruiz J. Carrion's Disease: the Sound of Silence. Clin Microbiol Rev. 2017;31(1):e00056-17. Published 2017 Nov 29. doi:10.1128/CMR.00056-17
Verruga Peruana
Verruga peruana manifests as multiple skin lesions that strongly resemble bacillary angiomatosis; these raised, reddish purple skin nodules usually occur on the limbs and face. The lesions may persist for months to years and may be accompanied by pain and fever.
Verruga peruana is diagnosed by its appearance and sometimes by biopsy showing dermal angiogenesis.
Treatment with most antibiotics induces remission, but relapse is common and requires prolonged therapy.
