Summer Buzz

Polyxeni Potter

Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Novel Bartonella Agent as Cause of Verruga Peruana

David L. Blazes

, Kristin Mullins, Bonnie L. Smoak, Ju Jiang, Enrique Canal, Nelson Solorzano, Eric Hall, Rina Meza, Ciro Maguina, Todd Myers, Allen L. Richards, and Larry Laughlin

Author affiliations: Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA (D.L. Blazes, K. Mullins, B.L. Smoak, L. Laughlin); Walter Reed Army Institute of Research, Silver Spring, Maryland, USA (B.L. Smoak); Naval Medical Research Center, Silver Spring (J. Jiang, E. Hall, T. Myers, A.L. Richards); Naval Medical Research Unit 6, Lima, Peru (E. Canal, R. Meza); Hospital San Juan de Dios, Lima (N. Solorzano); Universidad Peruana Cayetano Heredia–Tropicales, Lima (C. Maguina)

Abstract

While studying chronic verruga peruana infections in Peru from 2003, we isolated a novel Bartonella agent, which we propose be named Candidatus Bartonella ancashi. This case reveals the inherent weakness of relying solely on clinical syndromes for diagnosis and underscores the need for a new diagnostic paradigm in developing settings.

Bartonellosis is a disease caused by infection with species from the Bartonella genus. In South America, infection with B. bacilliformis, an α-2 proteobacterium, may cause a life- threatening bacterial infection (1,2). If untreated, the acute form of the illness, sometimes referred to as Oroya fever, has a high mortality rate because the bacteria invade erythrocytes, resulting in subsequent severe anemia and secondary infections. A chronic phase, termed verruga peruana, is characterized by vasculoproliferative skin lesions; some reseachers have also described an asymptomatic bacteremic phase, which may contribute to the longevity of the reservoir status of infected persons (3).
In 2007, a novel species of Bartonella (B. rochalimae) was isolated from a single traveler who had an acute febrile anemia after traveling to Peru (4). We report the identification of another novel agent of Bartonella isolated from a patient with chronic bartonellosis (collected in 2003, fully characterized in 2011–2012). We suggest that the isolate be named Candidatus Bartonella ancashi in honor of the highland region of Peru.