Bartonellosis

Bartonellosis is a bacterial infection caused by the bacteria bartonella bacilliformis.

In individuals who have never been exposed before, it manifests as a flu-like illness with fever as the predominant symptom. 

In individuals who have had prior exposure and immunity it presents as skin nodules.

Where does it occur?

It occurs primarily in the mountainous regions of Peru, Ecuador and Columbia at altitudes of 2000 – 6000 feet

How is it transmitted?

It is transmitted by the bite of sand flies that primarily bite at night

Is it contagious from person to person?

No

What is the risk for travelers?

The risk is generally low, but higher if staying in primitive accommodations with mud floors, thatched roof and lack screens.

How soon after exposure will I develop symptoms?

Usually in 2-4 weeks, but could be as late as 1-2 months after exposure

What are the signs and symptoms?

In individuals who are experiencing the illness for the first time one commonly sees flu like illness which can occur gradually over a week with symptoms of fatigue, headache and low grade fever. Sometimes one can develop abrupt onset of fever, chills, sweats, muscle pain, joint pain and changes in mentation leading to coma in severe cases.

After resolution of the flu like illness one develops skin lesions over a period of 1-2 months in a variety of forms like small lumps, warts, flat patches etc.

Are there any lab tests to diagnose the illness?

Diagnosis is made by demonstrating the organism in blood smears during episodes of fever, or culturing the blood in special media or by PCR.

Is there any treatment?

Antibiotics like penicillin, tetracycline and chloramphenicol are effective in treating the illness

What preventive measures can be taken?

Stay in accommodations with screened shelters, non-mud flooring, and sleep with bed netting and apply insect repellant containing DEET. Avoid blood transfusions in areas where the illness is prevalent.

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