Bartonellosis remains a major problem in Peru, but many contemporary aspects of this disease have not been adequately described. We examined the cases of 145 symptomatic patients in Lima, Peru, in whom bartonellosis was diagnosed from 1969 through 1992, including 68 patients in the acute (hematic) phase and 77 patients in the eruptive (verruga) phase. In modern Peru, symptomatic patients who have acute-phase bartonellosis typically present with a febrile illness and systemic symptoms caused by profound anemia; most patients respond successfully to treatment with chloramphenicol. Patients who have eruptive-phase bartonellosis most often present with cutaneous verrugas but may have less specific symptoms, such as fever and arthralgias; diagnosis can be confirmed in such patients by Western immunoblotting, and most patients appear to respond to treatment with rifampin.

Tangible and intangible benefits were identified with respect to the interests of the parties involved. This has led to the incorporation of innovation for patients under acceptable conditions.

Helicobacter pylori is associated with gastritis, peptic ulcer disease, and gastric cancer. Since gastric cancer is common in Peru, eradication of H. pylori may help to reduce the occurrence of gastric cancer. This study involved three randomized trials to determine the efficacy of four different triple-drug therapy regimens. The most successful regimen was furazolidone combined with bismuth subsalicylate and amoxicillin, which eradicated infection in 82% of patients. Patients successfully treated were followed every 2-3 months to determine the recurrence rate of H. pylori infection. Of 105 patients with H. pylori eradication documented by pathology and culture, 52% (55) returned for follow-up endoscopy, and in 73% (40) of these 55 the infection recurred during the 8-month follow-up period. Thirty-five patients from whom H. pylori was eradicated and who were tested for antibodies to H. pylori remained consistently seropositive. Rapid recurrence of H. pylori infection after successful eradication suggests that measures other than antimicrobial therapy are needed to fight H. pylori in developing countries.