carrion's disease is also known as

1...trench fever

2...rocky mountain spotted fever

3...oroya fever

4...five day fever


Ans: 3


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

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

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: (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 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.

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.