Clinical Overview of Bartonella bacilliformis

Key points

  • Bartonella bacilliformis is a rare but potentially life-threatening infection spread by sand flies in some parts of South America.
  • Bartonella bacilliformis infection requires antibiotic treatment.
  • Consultation with an infectious disease specialist is recommended.
Verruga peruana, mular form

Overview

Bartonella bacilliformis, also called South American bartonellosis, is spread by sand flies in some regions of South America. Bartonella bacilliformis has two distinct phases: Oroya fever and verruga peruana, also called Peruvian warts.

For Everyone About Bartonella bacilliformis

Testing and diagnosis

The acute phase of B. bacilliformis infection (Oroya fever) is typically diagnosed by blood culture or direct observation of the bacteria in peripheral blood smears. Bartonella bacilliformis is a fastidious, slow-growing bacterium. Cultures should be held for a minimum of 21 days. It is often helpful for healthcare providers to alert the microbiology laboratory that B. bacilliformis is suspected to optimize conditions for growth.

For patients with suspected B. bacilliformis bacteremia, molecular testing (including polymerase chain reaction, PCR) can be performed on blood.

Verruga peruana is usually a clinical diagnosis based on presence of characteristic lesions and time spent in areas of South America where B. bacilliformis is known to occur.

Treatment

Infection with B. bacilliformis requires antibiotic treatment. Several antibiotics are effective against B. bacilliformis infections, including macrolides, fluoroquinolones, cephalosporins, doxycycline, and rifampin. More than one antibiotic is often used. Consult with an infectious disease expert about treatment options.

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)