Short Report: Verruga Peruana in an Italian Traveler from Peru

Matteelli, Alberto; Castelli, Francesco; Spinetti, Angiola; Bonetti, F; Graifenberghi, Severo; Carosi, Giampiero

doi:10.4269/ajtmh.1994.50.143

Cited by 28 publications

(8 citation statements)

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“…In short, Carrión's disease is a reemerging public health threat in several South American nations and to travelers who visit these countries [10], [30].…”

Section: Janus: the Two Faces Of Carrión's Diseasementioning

confidence: 99%

Oroya Fever and Verruga Peruana: Bartonelloses Unique to South America

et al. 2014

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Bartonella bacilliformis is the bacterial agent of Carrión's disease and is presumed to be transmitted between humans by phlebotomine sand flies. Carrión's disease is endemic to high-altitude valleys of the South American Andes, and the first reported outbreak (1871) resulted in over 4,000 casualties. Since then, numerous outbreaks have been documented in endemic regions, and over the last two decades, outbreaks have occurred at atypical elevations, strongly suggesting that the area of endemicity is expanding. Approximately 1.7 million South Americans are estimated to be at risk in an area covering roughly 145,000 km2 of Ecuador, Colombia, and Peru. Although disease manifestations vary, two disparate syndromes can occur independently or sequentially. The first, Oroya fever, occurs approximately 60 days following the bite of an infected sand fly, in which infection of nearly all erythrocytes results in an acute hemolytic anemia with attendant symptoms of fever, jaundice, and myalgia. This phase of Carrión's disease often includes secondary infections and is fatal in up to 88% of patients without antimicrobial intervention. The second syndrome, referred to as verruga peruana, describes the endothelialcell-derived, blood-filled tumors that develop on the surface of the skin. Verrugae are rarely fatal, but can bleed and scar the patient. Moreover, these persistently infected humans provide a reservoir for infecting sand flies and thus maintaining B. bacilliformis in nature. Here, we discuss the current state of knowledge regarding this life-threatening, neglected bacterial pathogen and review its host-cell parasitism, molecular pathogenesis, phylogeny, sand fly vectors, diagnostics, and prospects for control.

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“…In short, Carrión's disease is a reemerging public health threat in several South American nations and to travelers who visit these countries [10], [30].…”

Section: Janus: the Two Faces Of Carrión's Diseasementioning

confidence: 99%

Oroya Fever and Verruga Peruana: Bartonelloses Unique to South America

et al. 2014

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“…Bartonellosis is typically characterized by an acute phase of fever and hemolytic anemia followed by a second phase of cutaneous vascular lesions called "verruga peruana" (11). Recently there have been increases in the number of reported cases from areas where bartonellosis is endemic, along with an emergence of the disease in new locations and as a threat to travelers (1,5,6,12). This increasing disease burden, coupled with the recognition of other Bartonella spp.…”

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confidence: 99%

Serodiagnosis of Bartonella bacilliformis Infection by Indirect Fluorescence Antibody Assay: Test Development and Application to a Population in an Area of Bartonellosis Endemicity

et al. 2000

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Bartonella bacilliformis causes bartonellosis, a potentially life-threatening emerging infectious disease seen in the Andes Mountains of South America. There are no generally accepted serologic tests to confirm the disease. We developed an indirect fluorescence antibody (IFA) test for the detection of antibodies toB. bacilliformis and then tested its performance as an aid in the diagnosis of acute bartonellosis. The IFA is 82% sensitive in detecting B. bacilliformis antibodies in acute-phase blood samples of laboratory-confirmed bartonellosis patients. When used to examine convalescent-phase sera, the IFA is positive in 93% of bartonellosis cases. The positive predictive value of the test is 89% in an area of Peru where B. bacilliformis is endemic and where the point prevalence of infection is 45%.

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“…Peru receives more than 700,000 tourists yearly (37). Although the illness seems to be outside the most relevant tourist destinations, several imported Bartonella-like cases have been described in travelers to and immigrants from areas of endemicity (57,(61)(62)(63). Thus, in 1992, a chronic travel-related case of Carrion's disease was diagnosed in Italy 4 months after return from a lengthy journey (7 months) to Ancash, Peru.…”

Section: Carrion's Disease Outside Perumentioning

confidence: 99%

Carrion's Disease: the Sound of Silence

2018

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Carrion's disease (CD) is a neglected biphasic vector-borne illness related to . It is found in the Andean valleys and is transmitted mainly by members of the genus but also by blood transfusions and from mother to child. The acute phase, Oroya fever, presents severe anemia and fever. The lethality is high in the absence of adequate treatment, despite the organism being susceptible to most antibiotics. Partial immunity is developed after infection by , resulting in high numbers of asymptomatic carriers. Following infection there is the chronic phase, Peruvian warts, involving abnormal proliferation of the endothelial cells. Despite potentially being eradicable, CD has been expanded due to human migration and geographical expansion of the vector. Moreover, studies have demonstrated the risk of the development of antimicrobial resistance. These findings, together with the description of new species producing CD-like infections, the presence of undescribed potential vectors in new areas, the lack of adequate diagnostic tools and knowledge of the immunology and bacterial pathogenesis of CD, and poor international visibility, have led to the risk of increasing the potential expansion of resistant strains which will challenge current treatment schemes as well as the possible appearance of CD in areas where it is not endemic.

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Short Report: Verruga Peruana in an Italian Traveler from Peru

Cited by 28 publications

References 0 publications

Oroya Fever and Verruga Peruana: Bartonelloses Unique to South America

Oroya Fever and Verruga Peruana: Bartonelloses Unique to South America

Serodiagnosis of Bartonella bacilliformis Infection by Indirect Fluorescence Antibody Assay: Test Development and Application to a Population in an Area of Bartonellosis Endemicity

Carrion's Disease: the Sound of Silence

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