Carrion's disease

Carrion's disease is named after Daniel Alcides Carrión, a medical student who died after inoculating himself with Bartonella bacilliformi in order to prove it was the cause of the disease. Bacteriologist Hideyo Noguchi alongside fellow researcher Evelyn Tilden continuing his research after his death proved Carrion's disease and verruga peruana were the same disease. Cases of Carrion's disease that identified in the 20th century were found to be caused by Bartonella bacilliformi. However, in the 21st century, cases of bartenellosis with a similar presentation of Carrion's disease were found to be infected with other species of Bartonella, including B. rochalimae and B. ancashensis. ==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). An individual can be affected by either or both phases. Acute phase The acute phase is also called the hematic phase or Oroya fever. Mortality is often thought to be due to subsequent infections due to the weakened immune system and opportunistic pathogen invasion, or consequences of malnutrition due to weight loss in children. In a study focusing on pediatric and gestational effects of the disease, mortality rates for pregnant women with the acute phase were estimated at 40% and rates of spontaneous abortion in another 40%. The chronic phase is the more common phase. Mortality during the chronic phase is very low. ==Transmission and cause==

Carrion's disease is caused by Bartonella bacilliformis. It is transmitted by sandfly bites in the genus Lutzomyia. These sandflies live in the ravines and valleys of the Andes Mountains; primarily in Peru, but also in Colombia and Ecuador. ==Diagnosis==

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

Treatment for Carrion's disease is with antibiotics. Because Carrion's disease is often comorbid with Salmonella infections, chloramphenicol has historically been the antibiotic of choice. ==Society and culture==

The disease was featured in an episode of The WB supernatural drama Charmed that aired on February 3, 2000. In the episode Piper Halliwell becomes infected when a sandfly bites her while she is importing a crate of Kiwano for her club, P3. Piper slowly begins to die of the condition as her sisters Prue and Phoebe rush to find a magical way to save her. ==References==