Bartonella spp are fastidious bacteria that occur in the blood of man and mammals; they are usually vector borne but can also be transmitted by animal scratches and bites. The bartonelloses of medical importance comprise Carrión's disease, trench fever, cat-scratch disease, bacillary angiomatosis, and peliosis hepatis. Carrión's disease, known as Oroya fever in the acute phase and verruga peruana (Peruvian wart) in its chronic form, has curious manifestations that, until recently, have been restricted in their geographic distribution to dwellers of the high, dry Andean valleys, but new sites of disease are emerging. Trench fever is associated with louse-borne disease and homelessness. Cat-scratch disease, bacillary angiomatosis, and peliosis hepatis are increasingly being recognized as causes of human disease, especially in susceptible population groups such as HIV-infected persons. The Bartonella spp are considered emerging human pathogens. The clinical manifestations, differential diagnosis, laboratory diagnosis, and treatment of these conditions are discussed.

Abstract. The natural cycle of Bartonella bacilliformis remains uncertain, and the suspected existence of animal reservoirs for the bacterium has never been convincingly demonstrated. We conducted a survey of Bartonella species infecting intradomicillary animals in a bartonellosis-endemic region of Peru, obtaining blood from 50 animals living in the homes of 11 families whose children had recently had bartonellosis. Bartonella-like bacteria were recovered from four of nine small rodents included in the study, but from none of the 41 domesticated animals. Identification and comparison of these isolates, and two Bartonella-like isolates obtained from Phyllotis mice in a different endemic region of Peru using serologic and genotypic methods indicated that although none were strains of B. bacilliformis, five were probably representatives of three previously unrecognized Bartonella species and one was a likely strain of the pathogenic species B. elizabethae.

Perú is a country with a large number of medicinal plants, many of which are used for the treatment of infectious diseases, 1) although only few studies have been conducted to prove their efficacy and safety. 2,3) Due to the emergence of micro-organism resistance to the common antibiotics 4) and its worldwide impact on health, our research aims to identify new natural products that may lead to the discovery of new antibacterial agents with higher efficiency and lower toxicity.As part of our continuing work on bioactive compounds from Peruvian medicinal plants, [5][6][7] the in vitro antimycobacterial activity of 102 ethanol extracts from 84 plants-used traditionally in Perú for the treatment of inflammatory or infectious disorders-was screened using a tetrazolium microplate assay (TEMA).8) In a separate screening, the antifungal and larvicidal activities of over 100 plants, including those previously tested for antimycobacterial activity, were bio-assayed.As a result of these screenings, Swartzia polyphylla DC (Fabaceae) was found to exhibit powerful antimycobacterial action against the sensitive H 37 Rv and multidrug-resistant Mycobacterium tuberculosis. It also inhibited the in vitro growth of the dermatophyte Trichophyton mentagrophytes, and was active against the larvae of the mosquito Culex quinquefasciatus. We are now pleased to report the isolation of the larvicidal, antimycobacterial and antifungal principles present in the crude extract of S. polyphylla.A solvent-partition of the 95% ethanol extract showed that the larvicidal and antimycobacterial activities were concentrated in the hexane fraction, while the 90% methanol fraction was active only in the antifungal assay. The hexane fraction (28 g) was chromatographed on a silica gel column using a hexane-chloroform-methanol gradient. Each fraction (F1-F7) was evaluated for larvicidal and antimycobacterial activity in vitro. The most active fraction (F6, 8.7 g) was purified by column chromatography using a hexanedichloromethane-ethanol gradient and then by MPLC (Lobar Lichroprep silica gel RP-8, 40-63 mm, 310ϫ25 mm, Merck) with acetonitrile-methanol-water (3 : 2 : 2) yielding the most active fraction F-6-4-2 (51.4 mg). This fraction was finally purified by HPLC (Waters Nova-pak H R silica 6 mm, 3.9ϫ300 mm, Waters Model 600E with Waters 2996 PDA detector) using hexane-chloroform gradient (0 to 70%) to obtain T-cadinol (1, 9 mg) (Fig. 1). 9,10) The 90% methanol fraction (25.5 g) was subjected to column chromatography (silica gel, 0.063-0.200 mm) using a hexane-chloroform-methanol gradient. Each fraction (F1-F9) was tested for antifungal activity in vitro. The most active fraction (F3) yielded fraction F3-7-5 (756 mg) after repeated column chromatography using hexane-ethylacetatemethanol as eluent. This fraction was finally purified by MPLC with methanol-water (6 : 4) to afford biochanin A (2, 15 mg) and dihydrobiochanin A (3, 59 mg) (Fig. 1). 11)The bark of S. polyphylla contains various flavonoids and isoflavones, some of them with strong activity against...