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Carrión's disease

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A historic term for bartonellosis. A disease occurring in the valleys in the Andes Mountains in Peru, Chile, Bolivia, and Columbia at altitudes of 600 to 3.700 meters. It is a generalized, acute, febrile, endemic, and systemic form of bartonellosis that appears in an acute febrile anaemic stage followed in several weeks by a nodular skin eruption. Two forms are recognized: the mild form verruga peruana and the severe form Oroya fever. The mild form is characterized by mild anemia and either miliary or nodular eruptions resembling Kaposi's sarcoma. The severe form is characterized by acute fever, pernicious anemia, and muscular pain and weakness.

Already in 1764 the Spanish-born Peruvian physician, chronicler, cosmographer, and mathematician Cosme Bueno (1711-1798) wrote that Andean peoples of Peru attributed the diseases now known as leishmaniasis and bartonellosis to the bite of the uta or sand fly.

Alberto Leopoldo Barton (1871-1950) identified the parasite which causes Oroya fever and Verruga peruana in 1909. The disease is caused by Bartonella bacilliformis and transmitted by the sandfly Phlebotomus verrucarum. Other suspected vectors are Phlebotomus noguchi and Phlebotomus peruensis. The reservoir for Bartonella bacilliformis is chiefly people in symptom free cases and in the verruga stage.

Bibliography

  • Cosme Bueno:
    La erupción en la infermadad de Carrión (verruga peruviana). El Conocimiento de los Tiempos. Epheméride del año 1761, Bisiesto: en que van puestos los principales Aspectos de la Luna con los Astros, y de ellos entre sí. Calculado por las tablas de Cassini para el meridiano de esta muy noble, y muy leal Ciudad de Lima, Capital, y Emporio de esta América Meridional. Con Calendario de las Fiestas y Santos en que van notados los días Feriados de los Tribunales con esta señal F. Los de trabajo, con obligación de oír Misa, con ésta (*). Los de Fiesta con ésta X, y los de precepto para los Indios con ésta XX. 1764.
  • Ernest Odriozola (1862-1921):
    La erupción en la infermadad de Carrión (verruga peruviana).
    El monitor médico, Lima, 1895, 10: 309-311.
    Odriozola introduced the term Carrión's disease
  • A. L. Barton:
    Descripción de elementos endo-globulares hallados en las enfermos de fiebre verrucosa.
    La Crónica médica de Lima, 1909, 26: 7-10.
    Barton identified the parasite which causes Oroya fever and Verruga peruana.
  • C. H. T. Townsend:
    The transmission of Verruga by Phlebotomus.
    The Journal of the American Medical Association, Chicago 1913, 61: 1717.
    In 1913, Charles H. T. Townsend, the entomologist, found a species of Phlebotomus whose bite caused the outbreak of the disease. He named the mosquito Phlebotomus verrucarum.
  • Hideyo Noguchi (1876-1928), R. C. Shannon, E. B. Tilden, J. R. Tyler:
    Etiology of Oroya fever. XIV: The insect vectors of Carrión’s disease.
    The Journal of Experimental Medicine, New York, 1928, 47: 993-1008.
    By cultivating Bartonella bacilliformis from Oroya fever- and verruga-patients in the years 1926-1927, Hideyo Noguchi (himself a victim of his research on yellow fever), was able to demonstrate that Oroya fever and verruga are two manifestations of the same infection.
  • Marshall Hertig:
    Phlebotomus and Carrión’s disease.
    The American Journal of Tropical Medicine & Hygiene, Baltimore 1942, 22 (Supplement): 1-81.
    The role of the sandfly as a vector of the disease was definitely established by Marshall Hertig, who, in the years 1937 to 1941, conducted extensive studies of the verruga valleys.

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