Oroya Fever
Hematologic disease caused by Bartonella ...
89
Description

Oroya Fever
Hematologic disease caused by Bartonella bacilliformis
Restricted to the Andes highlands of Peru & Ecuador
B. bacilliformis:
 - Gram negative, Facultative intracellular, Aerobic
 - Cocci, coccobacillus
 - Incubation period: 3-12 weeks
 - Vector: Sandfly — Mainly, Lutzomyia verrucarum
Clinical Presentation ​- Acute Phase (Days-Weeks):
 • Variable: asymptomatic to highly symptomatic.
 ​• Inflammation: high fever, malaise, chills, anorexia, ARDS
 ​• RBC lysis  → severe hemolytic anemia, jaundice
 ​• Neuro: AMS (carries bad prognosis!)
 ​• Transient immunosuppression → look for Salmonella coinfection, toxo reactivation
Clinical Presentation ​- Chronic Phase (Months-Years):
 ​• Miliar → Nodular → Mular
DIAGNOSIS:
 ​• Acute phase: Peripheral smear - Cocci & coccobacillus within the RBCs
 ​• Chronic phase: Derm findings, biopsy
 ​• Isolation using Columbia Agar → takes 2-4 weeks for a result.
TREATMENT:
 ​• Acute phase: Supportive and antibiotics: ciprofloxacin, chloramphenicol.
 ​• Chronic phase: rifampicin + azithromycin

by Gabriel Talledo MD(c) @gabrieltalledop

#Oroya #Fever #diagnosis #management #Bartonella #bacilliformis
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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