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
