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Am. J. Trop. Med. Hyg., 71(1), 2004, pp. 53-55
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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REPORT OF AN UNUSUAL CASE OF PERSISTENT BACTEREMIA BY BARTONELLA BACILLIFORMIS IN A SPLENECTOMIZED PATIENT

CÉSAR HENRÍQUEZ, JUAN CARLOS HINOJOSA, PALMIRA VENTOSILLA, BERONICA INFANTE, JENNY MERELLO, VANIA MALLQUI, MANUELA VERASTEGUI, AND CIRO MAGUIÑA
Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru; Departamento de Patología y Departamento de Microbiología, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Transmisibles y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru

We report a case of a 56-year-old man with a history of splenectomy for idiopathic thrombocytopenic purpura who developed persistent bacteremia in the acute phase of human bartonellosis. This patient did not develop hemolytic anemia. Only after several courses of antibiotic treatment was the infection eradicated. This is an unusual case of overwhelming post-splenectomy infection by Bartonella bacilliformis, which provides clinical evidence that the spleen is a critical effector organ of clearance of this infection as well as the effector organ of bartonellosis-associated hemolytic anemia.

Received September 17, 2003. Accepted for publication October 17, 2003.

Acknowledgments: We thank Dr. Humberto Guerra, Dr. Bonnie Smoak, Dr. Joseph Vinetz, Maggie Pickerel, Dr. Jesús González, and Dr. Robert Gilman for reviewing the manuscript.

Authors’ addresses: César Henríquez, Juan Carlos Hinojosa, Palmira Ventosilla, Beronica Infante, Jenny Merello, and Ciro Maguiña, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, AP 4314, Lima 100, Peru. Vania Mallqui and Manuela Verastegui, Laboratorio de Patología, Hospital Nacional Cayetano Heredia, Av. Honorio Delgado s/n, Urb. Ingenieria, San Martin de Porres, Lima 100, Peru.

Reprint requests: César Henríquez, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, AP 4314, Lima 100, Peru, Telephone: 51-1-482-3910, Fax: 51-1-482-3403, E-mails: 03873{at}upch.edu.pe and cajhc{at}hotmail.com.






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