Bartonellosis (Carrion's disease) in the modern era." Clin Infect Dis 33(6

Bartonellosis remains a major problem in Peru, but many contemporary aspects of this disease have not been adequately described. We examined the cases of 145 symptomatic patients in Lima, Peru, in whom bartonellosis was diagnosed from 1969 through 1992, including 68 patients in the acute (hematic) phase and 77 patients in the eruptive (verruga) phase. In modern Peru, symptomatic patients who have acute-phase bartonellosis typically present with a febrile illness and systemic symptoms caused by profound anemia; most patients respond successfully to treatment with chloramphenicol. Patients who have eruptive-phase bartonellosis most often present with cutaneous verrugas but may have less specific symptoms, such as fever and arthralgias; diagnosis can be confirmed in such patients by Western immunoblotting, and most patients appear to respond to treatment with rifampin. Bartonellosis, or Carrión’s disease, is a bacterial infection that was recognized in the pre-Columbian era and re-mains endemic in some river valleys of the Andes Moun-tains of Peru, as well as in some regions of Colombia and Ecuador [1, 2]. The causative organism, Bartonella bacilliformis, is a small ( mm) pleomorphic,0.2–0.5 1–