A medical student reading about Bartonella species learns that one member of the genus differs sharply from B. henselae and B. quintana in its geography, vector, and clinical course. This species, which causes an acute haemolytic anaemia followed months later by eruptive angiomatous skin lesions, is endemic to which region and transmitted by which vector?

• A Mediterranean basin, transmitted by the sandfly Phlebotomus
• B Sub-Saharan Africa, transmitted by the tsetse fly Glossina
• C Southeast Asia, transmitted by the tick Ixodes
• D Andean valleys of South America, transmitted by the sandfly Lutzomyia ✓

Explanation

Bartonella bacilliformis causes Carrión disease, confined to Andean river valleys of Peru, Ecuador, and Colombia. The sandfly Lutzomyia verrucarum transmits it, producing Oroya fever, a severe acute haemolytic anaemia with organisms visible inside erythrocytes, followed by the chronic cutaneous eruption called verruga peruana. Tsetse flies transmit African trypanosomiasis, and Phlebotomus sandflies transmit leishmaniasis and bartonellosis elsewhere, not this species.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.