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Bartonellosis Oroya fever — DTM&H MCQ

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HardTropical bacterial infectionsBartonellosis Oroya feverDTM&H

A young man from a Peruvian Andean valley has an acute febrile haemolytic anaemia; several weeks later he develops friable angiomatous skin nodules. Which infection explains both phases?

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Correct answer: C — Bartonella bacilliformis infection causing Carrion disease

The best answer is “Bartonella bacilliformis infection causing Carrion disease”. Carrion disease is the biphasic B. bacilliformis infection of Andean valleys: erythrocyte invasion produces Oroya fever and severe haemolysis, followed by endothelial proliferation producing verruga peruana. B. henselae can cause vascular skin lesions in immunosuppression but not this classic Andean biphasic syndrome; leishmaniasis, malaria and typhus do not cause the same later angioproliferative eruption.

Reference: Clinical Microbiology Reviews, Carrion disease: the sound of silence: https://pmc.ncbi.nlm.nih.gov/articles/PMC5740975/