Oroya fever

WordNet

1. a rise in the temperature of the body; frequently a symptom of infection (同)febrility, febricity, pyrexia, feverishness
2. intense nervous anticipation; "in a fever of resentment"
3. highly excited; "a fevered imagination"

PrepTutorEJDIC

1. 〈U〉《しばしばa fever》(身体の異常な)『熱』,発熱 / 〈U〉『熱病』 / 〈U〉〈C〉(…に対する)『興奮』,熱狂《+『for』+『名』》
2. (比較変化なし)《名詞の前にのみ用いて》熱のある,熱病にかかった / 熱にうかされたような,興奮した / (憎しみなどが)異常に強い

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/25 14:05:13」(JST)

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Carrion's disease
Classification and external resources
Specialty	Infectious disease
ICD-10	A44.0 (ILDS A44.800)
ICD-9-CM	088
DiseasesDB	1249
MeSH	D001474

Oroya fever or Carrion's disease is an infectious disease produced by Bartonella bacilliformis infection.

It is named after Daniel Alcides Carrión.

History

Huaco from Ancash

Carrion's disease has been known since Pre-Inca times. Numerous artistic representations in clay (called "huacos") of the chronic phase have been found in endemic areas. The Spanish chronist, Garcilaso De La Vega described a disease with warts in Spanish troops during the conquest of Inca Empire, in Coaque-Ecuador. For a long time it was thought that the disease was endemic only in Peru and that it had only one phase, the "Peruvian wart" or "verruga peruana"

In 1875 an outbreak, characterized by fever and anemia occurred in the region of construction of the railroad line between Lima and La Oroya. This is the source of the name "oroya fever" sometimes used to describe acute bartonellosis.

In August 1885, Daniel Alcides Carrión, a Peruvian medical student, attempted to inoculate himself with material taken from a verruga lesion of a chronic patient (Carmen Paredes), with the help of a local physician (Evaristo Chavez). After 3 weeks he developed classic symptoms of the acute phase of the disease, thus establishing a common etiology (cause) for these two diseases. He died from bartonellosis on October 5, 1885 and was recognized as a martyr of Peruvian medicine and the term Carrión's Disease is still used today (Peruvian Medicine Day is October 5 in honor to him).

Alberto Barton, a Peruvian microbiologist, identified Bartonella bacilliformis within erythrocytes in 1905, and announced the discovery of the etiologic agent (Barton bacillus) in 1909, which was called Bartonella bacilliformis.

Etiologic agent

It is caused by Bartonella bacilliformis. Recent investigations show that Candidatus Bartonella ancashi may cause verruga peruana, although it may not meet all of Koch's postulates. There is no experimental reproduction of the Peruvian wart in animals.

Epidemiology

Carrion's disease is found only in Peru, Ecuador, and Colombia. It is endemic in some areas of Peru and is caused by infection with the bacterium Bartonella bacilliformis and transmitted by sandflies of genus Lutzomyia.

Clinical signs and symptoms

The clinical symptoms of bartonellosis are pleomorphic and some patients from endemic areas may be asymptomatic. The two classical clinical presentations are the acute phase and the chronic phase, corresponding to the two different host cell types invaded by the bacterium (red blood cells and endothelial cells).

Acute phase: (Carrion's disease) the most common findings are fever (usually sustained, but with temperature no greater than 102 °F (39 °C)), pallor, malaise, nonpainful hepatomegaly, jaundice, lymphadenopathy, splenomegaly. This phase is characterized by severe hemolytic anemia and transient immunosuppression. The case fatality ratios of untreated patients exceeded 40% but reach around 90% when opportunistic infection with Salmonella spp occurs. In a recent study the attack rate was 13.8% (123 cases) and the case-fatality rate was 0.7%.

chronic phase

Chronic phase: (Verruga Peruana or Peruvian Wart) it is characterized by an eruptive phase, in which the patients develop a cutaneus rash produced by a proliferation of endothelial cells and is known as "Peruvian warts" or "verruga peruana". Depending of the size and characteristics of the lesions, there are three types: miliary (1–4 mm), nodular or subdermic and mular (>5mm). Miliary lesions are the most common.

The most common findings are bleeding of verrugas, fever, malaise, arthralgias, anorexia, myalgias, pallor, lymphadeopathy, and hepato-splenomegaly.

Diagnosis

thin blood film

Diagnosis during the acute phase can be made by obtaining a peripheral blood smear with Giemsa stain, Columbia-blood agar cultures, immunoblot, IFI, and PCR. Diagnosis during the chronic phase can be made using a Warthin-Starry stain of wart biopsy, PCR, and immunoblot.

Treatment

The drug of choice during the acute phase is Quinolones (such as ciprofloxacin) or Chloramphenicol in adults and Chloramphenicol plus beta lactams in children.

For the chronic phase, Rifampin or macrolides are used to treat both adults and children.

See also

• Verruga peruana

References

External links

• Oroya fever
• Human Bartonellosis caused by Bartonella bacilliformis

UpToDate Contents

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• 1. 南米バルトネラ症：オロヤ熱とペルー疣症 south american bartonellosis oroya fever and verruga peruana

English Journal

• Bartonella entry mechanisms into mammalian host cells.

• Eicher SC, Dehio C.SourceResearch Area Infection Biology, Biozentrum of the University of Basel, Klingelbergstrasse 70, CH-4056, Basel, Switzerland.
• Cellular microbiology.Cell Microbiol.2012 Aug;14(8):1166-73. doi: 10.1111/j.1462-5822.2012.01806.x. Epub 2012 May 16.
• The Gram-negative genus Bartonella comprises arthropod-borne pathogens that typically infect mammals in a host-specific manner. Bartonella bacilliformis and Bartonella quintana are human-specific pathogens, while several zoonotic bartonellae specific for diverse animal hosts infect humans as an inci
• PMID 22519749

Japanese Journal

• 新しい病原菌

• 三木 寛二,坂崎 利一
• 日本臨床微生物学雑誌 = The journal of the Japanese Society for Clinical Microbiology 5(4), 1-6, 1995-12-25
• NAID 10029430148

• Etiology of Oroya fever XV : Effect of immune serum on the course of Bartonella bacilliformis infection in Macacus rhests

• NOGUCHI H.
• J. Exp. Med. 49, 355-364, 1929
• NAID 30017420104

Related Links

• Oroya fever | definition of Oroya fever by Medical dictionary

Oroya fever [o-ro´yah] the acute febrile anemic stage of bartonellosis. O·ro·ya fe·ver a generalized, acute, febrile, endemic, and systemic form of bartonellosis; marked by high fever, rheumatic pains, progressive, severe anemia, and ...

• Oroya fever - RightDiagnosis.com - Right Diagnosis

Oroya fever symptoms, causes, diagnosis, and treatment information for Oroya fever (Bartonellosis) with alternative diagnoses, full-text book chapters, misdiagnosis, research treatments, prevention, and prognosis. ... Introduction ...

Related Pictures

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★リンクテーブル★

リンク元	「Rochalimaea infection」「Bartonella infection」「Oroya熱」

「Rochalimaea infection」

　　[★]

ロシャリメア感染症、ロシャリメア感染、Rochalimaea感染症

関

Bartonella infection、bartonellosis、Carrion's disease、Oroya fever、verruga peruana

「Bartonella infection」

　　[★]

バルトネラ感染症、バルトネラ感染、Bartonella感染症

関

bartonellosis、Carrion's disease、Oroya fever、Rochalimaea infection、verruga peruana

「Oroya熱」

　　[★]

英

Oroya fever

関

オロヤ熱