Carrion's disease (CD) is a neglected biphasic vector-borne illness related to Bartonella bacilliformis. It is found in the Andean valleys and is transmitted mainly by members of the Lutzomyia genus but also by blood transfusions and from mother to child. The acute phase, Oroya fever, presents severe anemia and fever. The lethality is high in the absence of adequate treatment, despite the organism being susceptible to most antibiotics. Partial immunity is developed after infection by B. bacilliformis, resulting in high numbers of asymptomatic carriers. Following infection there is the chronic phase, Peruvian warts, involving abnormal proliferation of the endothelial cells. Despite potentially being eradicable, CD has been expanded due to human migration and geographical expansion of the vector. Moreover, in vitro studies have demonstrated the risk of the development of antimicrobial resistance. These findings, together with the description of new Bartonella species producing CD-like infections, the presence of undescribed potential vectors in new areas, the lack of adequate diagnostic tools and knowledge of the immunology and bacterial pathogenesis of CD, and poor international visibility, have led to the risk of increasing the potential expansion of resistant strains which will challenge current treatment schemes as well as the possible appearance of CD in areas where it is not endemic.

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腐肉病：沉默之声 [评论]

腐肉病 (CD) 是一种被忽视的双相病媒传播疾病，与杆状巴尔通体有关。它发现于安第斯山谷，主要通过Lutzomyia属成员传播，但也通过输血和母婴传播。急性期奥罗亚热表现为严重贫血和发烧。尽管该微生物对大多数抗生素敏感，但如果没有足够的治疗，致死率很高。杆菌感染后会产生部分免疫力，导致大量无症状携带者。感染后进入慢性期，即秘鲁疣，涉及内皮细胞的异常增殖。尽管有可能被根除，但由于人类迁徙和传播媒介的地理扩张，CD 已经扩大。此外，体外研究已经证明了产生抗菌药物耐药性的风险。这些发现，加上产生 CD 样感染的新巴尔通体物种的描述、新领域中未描述的潜在载体的存在、缺乏足够的诊断工具以及 CD 免疫学和细菌发病机制的知识，以及国际知名度较差，导致耐药菌株潜在扩张的风险增加，这将挑战当前的治疗方案以及 CD 在非流行地区可能出现的情况。