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B.This act of scientific recklessness immortalized him and illustrates the high mor- tality associated with this disease if untreated, so it is recom- mended that B. bacilliformis infections should be treated with chloramphenicol or ciprofloxacin.The link between verruga peruana skin lesions and Oroya fever was demonstrated by a medical student, Carrion, who infected himself with aspirates from the skin lesions and died of Oroya fever.
B. bacilliformis, the original member of the genus, is responsible for Carrión disease, an acute hemolytic bacter- emia consisting of fevers and severe anemia (Oroya fever) followed by the development of chronic vasoproliferative nodules (verruga peruana, “Peruvian wart”). The disease is restricted to the Andes mountain regions of Peru, Ecuador, and Colombia, the endemic area of the sandfly vector Phle- botomus. After the bite of an infected sandfly, the bacteria enter the blood, multiply, and penetrate into erythrocytes and endothelial cells. This process increases the fragility of the infected cells and facilitates their clearance by the reticu- loendothelial system, leading to acute anemia. Myalgia, arthralgia, and headache are also common. This stage of illness ends with the development of humoral immunity. In the chronic stage of Carrión disease, 1- to 2-cm cutaneous nodules, often engorged with blood (“angioproliferative”), appear over the course of 1 to 2 months and may persist for months to years. The link between verruga peruana skin lesions and Oroya fever was demonstrated by a medical student, Carrión, who infected himself with aspirates from the skin lesions and died of Oroya fever. This act of scientific recklessness immortalized him and illustrates the high mor- tality associated with this disease if untreated, so it is recom- mended that B. bacilliformis infections should be treated with chloramphenicol or ciprofloxacin.
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