The Treatment of Carrion's Disease with Large Transfusions

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Carrion's disease (Oroya fever, or verruga peruana) is a disease limited geographically to certain ravines and valleys of the Andes Mountains, principally in Peru, to a limited extent in Ecuador and Colombia and possibly in Bolivia and Chile. The causative organism is Bartonella bacilliformis. According to present knowledge, this organism is transmitted to man by the bite of a night-flying insect, Phlebotomus verrucarum.

There are two phases of clinical importance in this disease. The first phase of the illness may consist of a period of rather mild symptoms, including moderate fever, general malaise, headache and pain in the bones. The patient may make an uneventful recovery from this phase or a very serious illness due to severe anemia may develop. It is believed that the organism directly invades the erythrocytes and eventually causes a rupture of each cell invaded. In the severe anemic form, the organism can be readily identified microscopically on an ordinary blood smear stained with Wright's stain (fig. 1).