{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:33:08Z","timestamp":1781134388663,"version":"3.54.1"},"reference-count":45,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2008,2,1]],"date-time":"2008-02-01T00:00:00Z","timestamp":1201824000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Carrion's disease is typically biphasic with acute febrile illness characterized by bacteremia and severe hemolytic anemia (Oroya fever), followed by benign, chronic cutaneous lesions (verruga peruana). The causative agent,\n            <jats:italic>Bartonella bacilliformis<\/jats:italic>\n            , is endemic in specific regions of Peru and Ecuador. We describe atypical infection in an expatriate patient who presented with acute splenomegaly and anemia 3 years after visiting Ecuador. Initial serology and PCR of the patient's blood and serum were negative for\n            <jats:italic>Bartonella henselae<\/jats:italic>\n            ,\n            <jats:italic>Bartonella quintana<\/jats:italic>\n            , and\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            . Histology of splenic biopsy was suggestive of bacillary angiomatosis, but immunohistochemistry ruled out\n            <jats:italic>B. henselae<\/jats:italic>\n            and\n            <jats:italic>B. quintana<\/jats:italic>\n            . Bacilli (isolate EC-01) were subsequently cultured from the patient's blood and analyzed using multilocus sequence typing, protein gel electrophoresis with Western blotting, and an immunofluorescence assay (IFA) against a panel of sera from patients with Oroya fever in Peru. The EC-01 nucleotide sequences (\n            <jats:italic>gltA<\/jats:italic>\n            and internal transcribed spacer) and protein band banding pattern were most similar to a subset of\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            isolates from the region of Caraz, Ancash, in Peru, where\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            is endemic. By IFA, the patient's serum reacted strongly to two out of the three Peruvian\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            isolates tested, and EC-01 antigen reacted with 13\/20 Oroya fever sera. Bacilliary angiomatosis-like lesions were also detected in the spleen of the patient, who was inapparently infected with\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            and who presumably acquired infection in a region of Ecuador where\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            was not thought to be endemic. This study suggests that the range of\n            <jats:italic>B. bacilliformis<\/jats:italic>\n            may be expanding from areas of endemicity in Ecuador and that infection may present as atypical clinical disease.\n          <\/jats:p>","DOI":"10.1128\/jcm.01207-07","type":"journal-article","created":{"date-parts":[[2007,12,20]],"date-time":"2007-12-20T01:45:47Z","timestamp":1198115147000},"page":"627-637","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":20,"title":["Isolation and Characterization of\n            <i>Bartonella bacilliformis<\/i>\n            from an Expatriate Ecuadorian"],"prefix":"10.1128","volume":"46","author":[{"given":"Shari L.","family":"Lydy","sequence":"first","affiliation":[{"name":"Rickettsial Zoonoses Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina E.","family":"Eremeeva","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Asnis","sequence":"additional","affiliation":[{"name":"Flushing Hospital Medical Center, Flushing, New York 11355"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Paddock","sequence":"additional","affiliation":[{"name":"Infectious Diseases Pathology Branch, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Silverman","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore Maryland 21201"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Dasch","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1995.52.354"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1997.57.174"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.32.4.942-948.1994"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198609000-00002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1099\/00207713-46-4-891"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.29.7.1299-1302.1991"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevOncog.v6.i1.40"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.11.4269-4271.2000"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/344054"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2003.tb07376.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(96)90229-1"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(97)90019-5"},{"key":"e_1_3_2_14_2","first-page":"97","volume":"14","year":"1956","unstructured":"Cuadra, M. 1956. 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