Thrombocytopenic purpura and acute bartonellosis (Carrions Disease) in Huaraz, Peru

Abstract

We report four cases of acute bartonellosis (positive blood smear for Bartonella bacilliformis), who were present as an important complication, the thrombocytopenic purpura syndrome, a barely described complication for acute bartonellosis. The four cases were hospitalized in the Victor Ramos Guardia Hospital, and all of them are from the endemic zone of Ancash; three are natives and one live 5 years ago in this place. The range of the age was 14 -33 years; the time of the disease, 14-30 days; the parasitic index, 2%-62%. They presented with anemia, fever, epistaxis, petechiae and purpura; two cases had jaundice and hepatoesplenomegaly. The haemoglobin was between 5,6 and 9,7 g/dL; the leukocyte count was between 6 000 to 46 000/mm3 and the platelets were between 5 000 to 20 000/mm3. The direct Coombs test, LE cell test and Elisa for HIV were negative.