Carrion's disease

Last updated
Carrion's disease
Other namesOroya fever
Verruga.jpg
Carrion's disease chronic phase—verruga peruana (Peruvian warts)
Specialty Infectious diseases   OOjs UI icon edit-ltr-progressive.svg

Carrion's disease is an infectious disease produced by Bartonella bacilliformis infection.

Contents

It is named after Daniel Alcides Carrión. [1]

Signs and symptoms

The clinical symptoms of bartonellosis are pleomorphic and some patients from endemic areas may be asymptomatic. The two classical clinical presentations are the acute phase and the chronic phase, corresponding to the two different host cell types invaded by the bacterium (red blood cells and endothelial cells). An individual can be affected by either or both phases. [2] [3]

Acute phase

It is also called the hematic phase or Oroya fever. [2] The most common findings are fever (usually sustained, but with temperature no greater than 102 °F (39 °C)), pale appearance, malaise, painless liver enlargement, jaundice, enlarged lymph nodes, and enlarged spleen. This phase is characterized by severe hemolytic anemia and transient immunosuppression. The case fatality ratios of untreated patients exceeded 40% but reach around 90% when opportunistic infection with Salmonella spp. occurs. In a recent study, the attack rate was 13.8% (123 cases) and the case-fatality rate was 0.7%.[ citation needed ]

Other symptoms include a headache, muscle aches, and general abdominal pain. [4] Some studies have suggested a link between Carrion's disease and heart murmurs due to the disease's impact on the circulatory system. In children, symptoms of anorexia, nausea, and vomiting have been investigated as possible symptoms of the disease. [2]

Most of the mortality of Carrion's disease occurs during the acute phase. Studies vary in their estimates of mortality. In one study, mortality has been estimated as low as just 1% in studies of hospitalized patients, to as high as 88% in untreated, unhospitalized patients. [2] In developed countries, where the disease rarely occurs, it is recommended to seek the advice of a specialist in infectious disease when diagnosed. [5] Mortality is often thought to be due to subsequent infections due to the weakened immune system and opportunistic pathogen invasion, or consequences of malnutrition due to weight loss in children. [2] [6] In a study focusing on pediatric and gestational effects of the disease, mortality rates for pregnant women with the acute phase were estimated at 40% and rates of spontaneous abortion in another 40%. [2]

Chronic phase

It is also called the eruptive phase or tissue phase, in which the patients develop a cutaneous rash produced by a proliferation of endothelial cells and is known as "Peruvian warts" or "verruga peruana". Depending on the size and characteristics of the lesions, there are three types: miliary (1–4 mm), nodular or subdermic, and mular (>5mm). Miliary lesions are the most common. The lesions often ulcerate and bleed. [4]

The most common findings are bleeding of verrugas, fever, malaise, arthralgias (joint pain), anorexia, myalgias, pallor, lymphadenopathy, and liver and spleen enlargement.[ citation needed ]

On microscopic examination, the chronic phase and its rash are produced by angioblastic hyperplasia, or the increased rates and volume of cell growth in the tissues that form blood vessels. This results in a loss of contact between cells and a loss of normal functioning. [2] [7]

The chronic phase is the more common phase. Mortality during the chronic phase is very low. [2] [4]

Cause

Carrion's disease is caused by Bartonella bacilliformis . [4] [7] Recent investigations show that Bartonella ancashensis may cause verruga peruana, [8] [9] [10] although it may not meet all of Koch's postulates. [11] There has been no experimental reproduction of the Peruvian wart in animals apart from Macaca mulatta , and there is little research on the disease's natural spread or impact in native animals. [12]

Diagnosis

Thin blood film Smear.jpg
Thin blood film

Diagnosis during the acute phase can be made by obtaining a peripheral blood smear with Giemsa stain, Columbia blood agar cultures, immunoblot, indirect immunofluorescence, and PCR. Diagnosis during the chronic phase can be made using a Warthin–Starry stain of wart biopsy, PCR, and immunoblot.

Treatment

Because Carrion's disease is often comorbid with Salmonella infections, chloramphenicol has historically been the treatment of choice. [5]

Fluoroquinolones (such as ciprofloxacin) or chloramphenicol in adults and chloramphenicol plus beta-lactams in children are the antibiotic regimens of choice during the acute phase of Carrion's disease. [5] Chloramphenicol-resistant B. bacilliformis has been observed. [2] [5]

During the eruptive phase, in which chloramphenicol is not useful, azithromycin, erythromycin, and ciprofloxacin have been used successfully for treatment. Rifampin or macrolides are also used to treat both adults and children. [2] [5]

Because of the high rates of comorbid infections and conditions, multiple treatments are often required. These have included the use of corticosteroids for respiratory distress, red blood cell transfusions for anemia, pericardiectomies for pericardial tamponades, and other standard treatments. [2] [13]

Society and culture

The disease was featured in an episode of The WB supernatural drama Charmed that aired on February 3, 2000. In the episode Piper Halliwell becomes infected with the condition after importing a crate of Kiwano for her club, P3. She is bitten by a sandfly that was alive in the crate, infecting her. Piper slowly begins to die of the condition as her sisters Prue and Phoebe rush to find a magical way to save her.

Related Research Articles

<span class="mw-page-title-main">Chagas disease</span> Mammal parasitic disease

Chagas disease, also known as American trypanosomiasis, is a tropical parasitic disease caused by Trypanosoma cruzi. It is spread mostly by insects in the subfamily Triatominae, known as "kissing bugs". The symptoms change over the course of the infection. In the early stage, symptoms are typically either not present or mild, and may include fever, swollen lymph nodes, headaches, or swelling at the site of the bite. After four to eight weeks, untreated individuals enter the chronic phase of disease, which in most cases does not result in further symptoms. Up to 45% of people with chronic infections develop heart disease 10–30 years after the initial illness, which can lead to heart failure. Digestive complications, including an enlarged esophagus or an enlarged colon, may also occur in up to 21% of people, and up to 10% of people may experience nerve damage.

<span class="mw-page-title-main">Typhoid fever</span> Disease caused by the bacteria Salmonella Typhi

Typhoid fever, also known as typhoid, is a disease caused by Salmonella serotype Typhi bacteria. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over several days. This is commonly accompanied by weakness, abdominal pain, constipation, headaches, and mild vomiting. Some people develop a skin rash with rose colored spots. In severe cases, people may experience confusion. Without treatment, symptoms may last weeks or months. Diarrhea may be severe, but is uncommon. Other people may carry it without being affected, but are still contagious. Typhoid fever is a type of enteric fever, along with paratyphoid fever. S. enterica Typhi is believed to infect and replicate only within humans.

<span class="mw-page-title-main">Hepatitis</span> Inflammation of the liver

Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Chronic hepatitis may progress to scarring of the liver (cirrhosis), liver failure, and liver cancer.

<span class="mw-page-title-main">Psittacosis</span> Infectious disease in humans

Psittacosis—also known as parrot fever, and ornithosis—is a zoonotic infectious disease in humans caused by a bacterium called Chlamydia psittaci and contracted from infected parrots, such as macaws, cockatiels, and budgerigars, and from pigeons, sparrows, ducks, hens, gulls and many other species of birds. The incidence of infection in canaries and finches is believed to be lower than in psittacine birds.

<span class="mw-page-title-main">Chikungunya</span> Infection caused by the Chikungunya virus

Chikungunya is an infection caused by the Chikungunya virus (CHIKV). Symptoms include fever and joint pains. These typically occur two to twelve days after exposure. Other symptoms may include headache, muscle pain, joint swelling, and a rash. Symptoms usually improve within a week; however, occasionally the joint pain may last for months or years. The risk of death is around 1 in 1,000. The very young, old, and those with other health problems are at risk of more severe disease.

<span class="mw-page-title-main">Viral hepatitis</span> Liver inflammation from a viral infection

Viral hepatitis is liver inflammation due to a viral infection. It may present in acute form as a recent infection with relatively rapid onset, or in chronic form, typically progressing from a long-lasting asymptomatic condition up to a decompensated hepatic disease and hepatocellular carcinoma (HCC).

<i>Bartonella henselae</i> Species of bacterium

Bartonella henselae, formerly Rochalimæa henselae, is a bacterium that is the causative agent of cat-scratch disease (bartonellosis).

<i>Bartonella</i> Genus of bacteria

Bartonella is a genus of Gram-negative bacteria. It is the only genus in the family Bartonellaceae. Facultative intracellular parasites, Bartonella species can infect healthy people, but are considered especially important as opportunistic pathogens. Bartonella species are transmitted by vectors such as ticks, fleas, sand flies, and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.

<i>Lutzomyia</i> Genus of flies

Lutzomyia is a genus of phlebotomine sand flies consisting of nearly 400 species, at least 33 of which have medical importance as vectors of human disease. Species of the genus Lutzomyia are found only in the New World, distributed in southern areas of the Nearctic and throughout the Neotropical realm. Lutzomyia is one of the two genera of the subfamily Phlebotominae to transmit the Leishmania parasite, with the other being Phlebotomus, found only in the Old World. Lutzomyia sand flies also serve as vectors for the bacterial Carrion's disease and a number of arboviruses.

Eosinophilic pneumonia is a disease in which an eosinophil, a type of white blood cell, accumulates in the lungs. These cells cause disruption of the normal air spaces (alveoli) where oxygen is extracted from the atmosphere. Several different kinds of eosinophilic pneumonia exist and can occur in any age group. The most common symptoms include cough, fever, difficulty breathing, and sweating at night. Eosinophilic pneumonia is diagnosed by a combination of characteristic symptoms, findings on a physical examination by a health provider, and the results of blood tests and X-rays. Prognosis is excellent once most eosinophilic pneumonia is recognized and treatment with corticosteroids is begun.

Bartonellosis is an infectious disease produced by bacteria of the genus Bartonella. Bartonella species cause diseases such as Carrión's disease, trench fever, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders.

<span class="mw-page-title-main">Endometritis</span> Medical condition

Endometritis is inflammation of the inner lining of the uterus (endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also part of spectrum of diseases that make up pelvic inflammatory disease.

Fever of unknown origin (FUO) refers to a condition in which the patient has an elevated temperature (fever) but, despite investigations by a physician, no explanation is found.

<span class="mw-page-title-main">Daniel Alcides Carrión</span> Peruvian medical student

Daniel Alcides Carrión García was a Peruvian medical student after whom Carrion's disease is named.

<span class="mw-page-title-main">Paracoccidioidomycosis</span> Medical condition

Paracoccidioidomycosis (PCM), also known as South American blastomycosis, is a fungal infection that can occur as a mouth and skin type, lymphangitic type, multi-organ involvement type (particularly lungs), or mixed type. If there are mouth ulcers or skin lesions, the disease is likely to be widespread. There may be no symptoms, or it may present with fever, sepsis, weight loss, large glands, or a large liver and spleen.

<i>Bartonella bacilliformis</i> Species of bacterium

Bartonella bacilliformis is a bacterium, Gram negative aerobic, pleomorphic, flagellated, motile, coccobacillary, 2–3 μm long, 0.2–0.5 μm wide, and a facultative intracellular bacterium.

Alberto Barton (1870-1950) was an Argentine-born Peruvian microbiologist who discovered the etiologic agent of Carrion´s disease or Oroya fever. The bacteria was named: Bartonella bacilliformis, in his honor. It is the type species of the genus Bartonella, and family Bartonellaceae.

There are several forms of Epstein–Barr virus (EBV) infection. These include asymptomatic infections, the primary infection, infectious mononucleosis, and the progression of asymptomatic or primary infections to: 1) any one of various Epstein–Barr virus-associated lymphoproliferative diseases such as chronic active EBV infection, EBV+ hemophagocytic lymphohistiocytosis, Burkitt's lymphoma, and Epstein–Barr virus positive diffuse large B-cell lymphoma, not otherwise specified); 2) non-lymphoid cancers such as Epstein–Barr virus associated gastric cancer, soft tissue sarcomas, leiomyosarcoma, and nasopharyngeal cancers; and 3) Epstein–Barr virus-associated non-lymphoproliferative diseases such as some cases of the immune disorders of multiple sclerosis and systemic lupus erythematosis and the childhood disorders of Alice in Wonderland Syndrome and acute cerebellar ataxia.

<span class="mw-page-title-main">Cat-scratch disease</span> Human disease

Cat-scratch disease (CSD) or felinosis is an infectious disease that most often results from a scratch or bite of a cat. Symptoms typically include a non-painful bump or blister at the site of injury and painful and swollen lymph nodes. People may feel tired, have a headache, or a fever. Symptoms typically begin within 3–14 days following infection.

Bartonella ancashensis is a bacterium from the genus Bartonella which has been isolated from blood from patients who suffered from verruga peruana in Caraz in Peru. Bartonella ancashensis is a human pathogen which may cause verruga peruana.

References

  1. ↑ synd/3112 at Who Named It?
  2. 1 2 3 4 5 6 7 8 9 10 11 Huarcaya, Erick; Maguiña, Ciro; Torres, Rita; Rupay, Joan; Fuentes, Luis (2004-10-01). "Bartonelosis (Carrion's Disease) in the pediatric population of Peru: an overview and update". Brazilian Journal of Infectious Diseases. 8 (5): 331–339. doi: 10.1590/S1413-86702004000500001 . ISSN   1413-8670. PMID   15798808.
  3. ↑ "Carrion's disease - RightDiagnosis.com". www.rightdiagnosis.com. Retrieved 2016-11-02.
  4. 1 2 3 4 "Bartonella Infection (Cat Scratch Disease, Trench Fever, and Carrión's Disease)". www.cdc.gov. Retrieved 2016-10-17.
  5. 1 2 3 4 5 "Bartonellosis - NORD (National Organization for Rare Disorders)". NORD (National Organization for Rare Disorders). Retrieved 2016-10-17.
  6. ↑ Maguina C, Garcia PJ, Gotuzzo E, Cordero L, Spach DH (September 2001). "Bartonellosis (Carrión's disease) in the modern era". Clin. Infect. Dis. 33 (6): 772–779. doi:10.1086/322614. PMID   11512081.
  7. 1 2 Maco V, Maguiña C, Tirado A, Maco V, Vidal JE (2004). "Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru". Rev. Inst. Med. Trop. Sao Paulo. 46 (3): 171–174. doi: 10.1590/S0036-46652004000300010 . PMID   15286824.
  8. ↑ Mullins KE, Hang J, Jiang J, Leguia M, Kasper MR, Maguiña C, Jarman RG, Blazes DL, Richards AL (2013). "Molecular Typing of "Candidatus Bartonella ancashi," a New Human Pathogen Causing Verruga Peruana". Journal of Clinical Microbiology. 51 (11): 3865–3868. doi: 10.1128/JCM.01226-13 . PMC   3889784 . PMID   23985925.
  9. ↑ Blazes DL, Mullins K, Smoak BL, Jiang J, Canal E, Solorzano N, et al. (2013). "Novel Bartonella agent as cause of verruga peruana". Emerging Infectious Diseases. 19 (7): 1111–1114. doi: 10.3201/eid1907.121718 . PMC   3713980 . PMID   23764047.
  10. ↑ Mullins KE, Hang J, Jiang J, Leguia M, Kasper MR, Ventosilla P, Maguiña C, Jarman RG, Blazes D, Richards AL (2015). "Description of Bartonella ancashensis sp. nov., isolated from blood of two patients with verruga peruana". International Journal of Systematic and Evolutionary Microbiology. 65 (10): 3339–3343. doi: 10.1099/ijsem.0.000416 . PMID   26296673.
  11. ↑ Salinas-Flores, D (2014). "The new Bartonella ancashi to cause the Peruvian wart: Does Koch's postulates?". Acta Medica Peruana (in Spanish). 31 (1): 34–36. Retrieved 24 February 2023.
  12. ↑ Garcilla-Quintanilla M, Dichter AA, Guerra H, Kempf VA (2019). "Carrion's disease: more than a neglected disease". Parasites & Vectors. 12 (1): 141. doi: 10.1186/s13071-019-3390-2 . PMC   6434794 . PMID   30909982. 141.
  13. ↑ Camacho, Cesar Henriquez (7 December 2002). "Human Bartonellosis Caused By Bartonella Bacilliformis". University of Pittsburgh. Retrieved 2 November 2016.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.